Organization
JEBEDIAH S CHRISTY, D.D.S. - VIENNA, PLLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
JASON BERTOLLINI (PRS)
(866) 273-8204
Entity
Organization
Contact information
Practice address
501 GRAND CENTRAL AVE, VIENNA, WV 26105-2140
(866) 273-8204
(866) 803-4943
Mailing address
PO BOX 3189, SYRACUSE, NY 13220-3189
(866) 273-8204
(866) 803-4943
Taxonomy
Speciality
Code
Description
License number
State
122300000X
Dentist
Primary
4081
WV
Other
Enumeration date
06/30/2014
Last updated
06/30/2014
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