Individual
DR. MALINDA MAYNARD HUSSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
DDS, MSD
Contact information
Practice address
4502 MACCORKLE AVE SE STE C, CHARLESTON, WV 25304-1835
(304) 926-9260
(304) 926-9266
Mailing address
4502 MACCORKLE AVE SE STE C, CHARLESTON, WV 25304-1835
(304) 926-9260
(304) 926-9266
Taxonomy
Speciality
Code
Description
License number
State
122300000X
Dentist
0401410708
VA
122300000X
Dentist
3557
WV
1223D0004X
Dental Anesthesiology
3557
WV
1223P0221X
Pediatric Dentistry
Primary
3557
WV
207L00000X
Anesthesiology Physician
0401410708
VA
Other
Enumeration date
12/28/2006
Last updated
03/11/2022
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