Provider Demographics
NPI:1801200225
Name:WEST VIRGINIA UNIVERSITY SCHOOL OF DENTISTRY DBA UNIVERSITY HEALTH ASS
Entity Type:Organization
Organization Name:WEST VIRGINIA UNIVERSITY SCHOOL OF DENTISTRY DBA UNIVERSITY HEALTH ASS
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:MANAGER OF DENTAL BILLING
Authorized Official - Prefix:MS
Authorized Official - First Name:L. DIANE
Authorized Official - Middle Name:
Authorized Official - Last Name:HESS
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:304-293-2240
Mailing Address - Street 1:PO BOX 9401
Mailing Address - Street 2:
Mailing Address - City:MORGANTOWN
Mailing Address - State:WV
Mailing Address - Zip Code:26506-9401
Mailing Address - Country:US
Mailing Address - Phone:304-293-2240
Mailing Address - Fax:
Practice Address - Street 1:1 MEDICAL CENTER DRIVE
Practice Address - Street 2:
Practice Address - City:MORGANTOWN
Practice Address - State:WV
Practice Address - Zip Code:26506
Practice Address - Country:US
Practice Address - Phone:304-293-6208
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2014-06-13
Last Update Date:2014-06-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes390200000XStudent, Health CareStudent in an Organized Health Care Education/Training ProgramGroup - Single Specialty