| Bruceton Dental Pllc | |
|
128 Green Street Bruceton Mills WV 26525 | |
| (304) 379-8101 | |
| (304) 379-8102 |
| Full Name | Bruceton Dental Pllc |
|---|---|
| Speciality | Clinic/center - Dental |
| Location | 128 Green Street, Bruceton Mills, West Virginia |
| Authorized Official Name and Position | Scott Reo Okubo (DDS/OWNER) |
| Authorized Official Contact | 3043798101 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Bruceton Dental Pllc Po Box 147 Bruceton Mills WV 26525-0147 Ph: (304) 379-8101 | Bruceton Dental Pllc 128 Green Street Bruceton Mills WV 26525 Ph: (304) 379-8101 |
| NPI Number | 1215385935 |
|---|---|
| Provider Enumeration Date | 06/03/2016 |
| Last Update Date | 06/03/2016 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1215385935 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261QD0000X | Clinic/center - Dental | WV2976 (West Virginia) | Primary |
Bruceton Mills Family Dentistry Dental Clinic Medicare: Not Enrolled in Medicare Practice Location: 10 Memorial Dr, Bruceton Mills, WV 26525 Phone: 304-903-9062 |