Individual
DR. CHAD J LANCASTER
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Contact information
Practice address
715 ELK ST, GASSAWAY, WV 26624-1113
(304) 364-8565
Mailing address
715 ELK ST, PO BOX 307, GASSAWAY, WV 26624-1113
(304) 364-8565
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
3625
WV
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
3810000354
—
WV
Enumeration date
04/13/2006
Last updated
11/26/2012
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