Individual
DANIEL BRODY
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
DDS
Contact information
Practice address
#71 WAYNE STREET, FORT GAY, WV 25514-8518
(304) 648-5433
Mailing address
2585 3RD AVE, HUNTINGTON, WV 25703-1642
(304) 697-1396
(304) 697-2086
Taxonomy
Speciality
Code
Description
License number
State
122300000X
Dentist
Primary
2768
WV
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
0068952
—
OH
05
—
0137071000
—
WV
05
—
60690237
—
KY
Enumeration date
01/18/2006
Last updated
05/28/2024
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