| Charles E. Sammons, Dds | |
|
180 Mingo Avenue Kermit WV 25674-0248 | |
| (304) 393-1030 | |
| (304) 393-1026 |
| Full Name | Charles E. Sammons, Dds |
|---|---|
| Speciality | Dentist - General Practice |
| Location | 180 Mingo Avenue, Kermit, West Virginia |
| Authorized Official Name and Position | Charles E Sammons (OWNER) |
| Authorized Official Contact | 3043931030 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Charles E. Sammons, Dds 180 Mingo Avenue P.o. Box 248 Kermit WV 25674-0248 Ph: (304) 393-1030 | Charles E. Sammons, Dds 180 Mingo Avenue Kermit WV 25674-0248 Ph: (304) 393-1030 |
| NPI Number | 1417107889 |
|---|---|
| Provider Enumeration Date | 09/23/2008 |
| Last Update Date | 09/23/2008 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1417107889 | NPI | - | NPPES |
| 0136867000 | Medicaid | WV |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 1223G0001X | Dentist - General Practice | 2668 (West Virginia) | Primary |