Individual
DANIEL KELLY WILFONG
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
DDS
Contact information
Practice address
2905 DUDLEY AVE, PARKERSBURG, WV 26101
(304) 424-5002
(304) 422-5740
Mailing address
2905 DUDLEY AVE, PARKERSBURG, WV 26101
(304) 424-5002
(304) 422-5740
Taxonomy
Speciality
Code
Description
License number
State
122300000X
Dentist
Primary
30022126
OH
122300000X
Dentist
3699
WV
Other
Enumeration date
11/27/2007
Last updated
11/27/2007
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