Organization
MONROE COUNTY HEALTH CENTER
Active
Other names
Craig County Dental Center
Organization subpart
No
Provider details
NPI number
Authorized official
MICHELLE B BALLARD (COO)
(304) 772-3065
Entity
Organization
Contact information
Practice address
230 MARKET STREET, NEW CASTLE, VA 24127
(540) 864-5556
Mailing address
200 HEALTH CENTER DRIVE, PO BOX 590, UNION, WV 24983
(304) 772-3065
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
0401411129
VA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1548582034
—
VA
05
—
1548582034
—
WV
Enumeration date
02/24/2010
Last updated
09/28/2011
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