Individual
LON PATRICK SPAIN
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
DDS
Contact information
Practice address
408 ALEXANDER STREET, CEDAR GROVE, WV 25039
(304) 595-1770
Mailing address
PO BOX 1680, HUNTINGTON, WV 25717-1680
(304) 525-3334
(304) 697-2086
Taxonomy
Speciality
Code
Description
License number
State
122300000X
Dentist
Primary
3400
WV
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
2036862
—
OH
05
—
7100174300
—
KY
05
—
7805006000
—
WV
Enumeration date
01/24/2006
Last updated
09/17/2013
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