| Stephen C Mallow Dba Upper Tract Dental | |
|
9030 Petersburg Pike Upper Tract WV 26866-8014 | |
| (304) 358-7200 | |
| (304) 358-7284 |
| Full Name | Stephen C Mallow Dba Upper Tract Dental |
|---|---|
| Speciality | Dentist - General Practice |
| Location | 9030 Petersburg Pike, Upper Tract, West Virginia |
| Authorized Official Name and Position | Lisa D Mallow (OFFICE MANAGER) |
| Authorized Official Contact | 3043588152 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Stephen C Mallow Dba Upper Tract Dental 8791 Petersburg Pike Upper Tract WV 26866-8016 Ph: (304) 358-8152 | Stephen C Mallow Dba Upper Tract Dental 9030 Petersburg Pike Upper Tract WV 26866-8014 Ph: (304) 358-7200 |
| NPI Number | 1083395081 |
|---|---|
| Provider Enumeration Date | 07/31/2023 |
| Last Update Date | 08/03/2023 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1083395081 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 1223G0001X | Dentist - General Practice | (* (Not Available)) | Primary |