Provider Demographics
NPI:1801032073
Name:GHAREEB & SCARBERRY, D.D.S., PC
Entity Type:Organization
Organization Name:GHAREEB & SCARBERRY, D.D.S., PC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OFFICER
Authorized Official - Prefix:DR
Authorized Official - First Name:MITRI
Authorized Official - Middle Name:ALBERTO
Authorized Official - Last Name:GHAREEB
Authorized Official - Suffix:
Authorized Official - Credentials:DDS
Authorized Official - Phone:304-727-2222
Mailing Address - Street 1:PO BOX 566
Mailing Address - Street 2:
Mailing Address - City:POCA
Mailing Address - State:WV
Mailing Address - Zip Code:25159-0566
Mailing Address - Country:US
Mailing Address - Phone:304-755-3931
Mailing Address - Fax:
Practice Address - Street 1:2035 KANAWHA TER
Practice Address - Street 2:
Practice Address - City:SAINT ALBANS
Practice Address - State:WV
Practice Address - Zip Code:25177-3187
Practice Address - Country:US
Practice Address - Phone:304-727-2222
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-12-18
Last Update Date:2008-12-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WV37131223G0001X
WV37251223G0001X
WV36191223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1223G0001XDental ProvidersDentistGeneral PracticeGroup - Single Specialty