Provider Demographics
NPI:1871686089
Name:DYER, JAY HENRY (DDS)
Entity Type:Individual
Prefix:DR
First Name:JAY
Middle Name:HENRY
Last Name:DYER
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 1:2115 CHAPLINE ST
Mailing Address - Street 2:SU 208
Mailing Address - City:WHEELING
Mailing Address - State:WV
Mailing Address - Zip Code:26003-3859
Mailing Address - Country:US
Mailing Address - Phone:304-232-6956
Mailing Address - Fax:304-234-8824
Practice Address - Street 1:2115 CHAPLINE ST
Practice Address - Street 2:SU 208
Practice Address - City:WHEELING
Practice Address - State:WV
Practice Address - Zip Code:26003-3859
Practice Address - Country:US
Practice Address - Phone:304-232-6956
Practice Address - Fax:304-234-8824
Is Sole Proprietor?:Yes
Enumeration Date:2006-10-02
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WV1888122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist