Individual
TRAVIS GARY TOMBLYN
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
DDS, MS
Contact information
Practice address
1 FLATTS LN, MORGANTOWN, WV 26505-3840
(304) 613-7704
Mailing address
1 FLATTS LN, MORGANTOWN, WV 26505-3840
(304) 613-7704
Taxonomy
Speciality
Code
Description
License number
State
1223X0400X
Orthodontics and Dentofacial Orthopedics Dentistry
Primary
30704
TX
Other
Enumeration date
03/22/2015
Last updated
03/22/2015
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