Individual
JERRY L. PENNINGTON
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
DDS
Contact information
Practice address
497 MALL RD, OAK HILL, WV 25901-6216
(304) 574-2076
(304) 574-1068
Mailing address
497 MALL RD, OAK HILL, WV 25901-6216
(304) 469-2905
Taxonomy
Speciality
Code
Description
License number
State
122300000X
Dentist
Primary
2641
WV
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
3810009746
—
WV
Enumeration date
08/23/2007
Last updated
10/11/2023
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