Individual
MISS JENNIFER VAUGHAN
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
DDS
Contact information
Practice address
200 ORCHARD AVE, BRIDGEPORT, WV 26330-1737
(304) 842-3577
(304) 842-3231
Mailing address
200 ORCHARD AVE, BRIDGEPORT, WV 26330-1737
(304) 842-3577
(304) 842-3231
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
3871
WV
Other
Enumeration date
07/07/2009
Last updated
07/07/2009
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