Individual
DR. GREGORY CLARK BRISCOE
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
DDS
Contact information
Practice address
2018 MARTINS BRANCH RD, CHARLESTON, WV 25312-9457
(304) 984-0052
(304) 984-3140
Mailing address
PO BOX 13485, CHARLESTON, WV 25360-0485
(304) 984-0052
(304) 984-3140
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
2207
WV
Other
Enumeration date
06/09/2005
Last updated
10/18/2012
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