Organization
STADIUM DENTURE CENTER, INC.
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MARGIE ALLEN (PRESIDENT)
(304) 615-9852
Entity
Organization
Contact information
Practice address
3015 DUDLEY AVE, PARKERSBURG, WV 26104-1817
(304) 615-9852
Mailing address
3015 DUDLEY AVE, PARKERSBURG, WV 26104-1817
(304) 615-9852
Taxonomy
Speciality
Code
Description
License number
State
292200000X
Dental Laboratory
Primary
1045-4114
WV
Other
Enumeration date
12/08/2016
Last updated
12/08/2016
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