Individual
DR. AMELIA J POTESTA
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
1900 SCHOOL ST, KANAWHA DENTAL HEALTH COUNCIL INC, CHARLESTON, WV 25312
(304) 348-6613
Mailing address
1902 JOHNSON ROAD, CHARLESTON, WV 25314
Taxonomy
Speciality
Code
Description
License number
State
122300000X
Dentist
Primary
1844
WV
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
0012835000
—
WV
05
—
0133458000
—
WV
Enumeration date
04/10/2007
Last updated
07/09/2007
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