| Jerry Mounts Dds, Inc | |
|
Mate Street Matewan WV 25678 | |
| (304) 426-4161 | |
| (304) 426-4162 |
| Full Name | Jerry Mounts Dds, Inc |
|---|---|
| Speciality | Dentist - General Practice |
| Location | Mate Street, Matewan, West Virginia |
| Authorized Official Name and Position | Jerry Mounts (PRESIDENT) |
| Authorized Official Contact | 3044264161 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Jerry Mounts Dds, Inc Po Box 537 Matewan WV 25678-0537 Ph: (304) 426-4161 | Jerry Mounts Dds, Inc Mate Street Matewan WV 25678 Ph: (304) 426-4161 |
| NPI Number | 1285728188 |
|---|---|
| Provider Enumeration Date | 10/03/2006 |
| Last Update Date | 08/22/2020 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1285728188 | NPI | - | NPPES |
| 0137275000 | Medicaid | WV |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 1223G0001X | Dentist - General Practice | 2741 (West Virginia) | Primary |