| H Richard Marshall Jr Dds Inc | |
|
120 Maplewood Ave Ronceverte WV 24970 | |
| (304) 645-3110 | |
| (301) 645-3209 |
| Full Name | H Richard Marshall Jr Dds Inc |
|---|---|
| Speciality | Dentist |
| Location | 120 Maplewood Ave, Ronceverte, West Virginia |
| Authorized Official Name and Position | Bonnie M Gragg (OFFICE MANAGER) |
| Authorized Official Contact | 3046453110 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| H Richard Marshall Jr Dds Inc 120 Maplewood Ave Ronceverte WV 24970 Ph: (304) 645-3110 | H Richard Marshall Jr Dds Inc 120 Maplewood Ave Ronceverte WV 24970 Ph: (304) 645-3110 |
| NPI Number | 1588753859 |
|---|---|
| Provider Enumeration Date | 10/12/2006 |
| Last Update Date | 08/22/2020 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1588753859 | NPI | - | NPPES |
| 0135577000 | Medicaid | WV |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 122300000X | Dentist | WV1914 (West Virginia) | Primary |
Christopher J Rodebaugh, Dds Inc Dental Clinic Medicare: Not Enrolled in Medicare Practice Location: 120 Maplewood Ave, Ronceverte, WV 24970 Phone: 304-645-3110 Fax: 304-645-3209 | |
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