Individual
ALBA SANJUAN SANJUAN
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MD
Contact information
Practice address
415 MORRIS ST STE 309, CHARLESTON, WV 25301
(304) 388-3290
(304) 388-3186
Mailing address
415 MORRIS ST STE 309, CHARLESTON, WV 25301-1853
(304) 388-3290
(304) 388-3186
Taxonomy
Speciality
Code
Description
License number
State
204E00000X
Oral & Maxillofacial Surgery (D.M.D.)
Primary
31823
WV
204E00000X
Oral & Maxillofacial Surgery (D.M.D.)
4352000978
MI
390200000X
Student in an Organized Health Care Education/Training Program
—
FL
Other
Enumeration date
07/23/2020
Last updated
09/25/2022
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