Organization
DR. RUSSELL TRITAPOE DDS PLLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. RUSSELL TRITAPOE DDS (OWNER)
(304) 298-3501
Entity
Organization
Contact information
Practice address
58 PRESIDENTS STREET, FORT ASHBY, WV 26719-0738
(304) 298-3501
(304) 298-3406
Mailing address
PO BOX 738, FORT ASHBY, WV 26719-0738
(304) 298-3501
(304) 298-3406
Taxonomy
Speciality
Code
Description
License number
State
122300000X
Dentist
Primary
3997
WV
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
3810025875
—
WV
Enumeration date
07/18/2015
Last updated
07/18/2015
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