Provider Demographics
NPI:1275552093
Name:SKAFF, ALEX WARREN (DDS)
Entity Type:Individual
Prefix:DR
First Name:ALEX
Middle Name:WARREN
Last Name:SKAFF
Suffix:
Gender:M
Credentials:DDS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:765 LOWER DONNALLY RD
Mailing Address - Street 2:
Mailing Address - City:CHARLESTON
Mailing Address - State:WV
Mailing Address - Zip Code:25304-2825
Mailing Address - Country:US
Mailing Address - Phone:304-925-7685
Mailing Address - Fax:
Practice Address - Street 1:1200 QUARRIER ST
Practice Address - Street 2:SIUTE #1
Practice Address - City:CHARLESTON
Practice Address - State:WV
Practice Address - Zip Code:25301-1830
Practice Address - Country:US
Practice Address - Phone:304-343-9855
Practice Address - Fax:304-343-2977
Is Sole Proprietor?:No
Enumeration Date:2006-07-19
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WVWV 18741223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice