Healthcare Provider Details

I. General information

NPI: 1356503049
Provider Name (Legal Business Name): JOSEPH GREG WROBLESKI D.D.S.
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 06/25/2008
Last Update Date: 06/27/2025
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

430 MORGANTOWN ST
KINGWOOD WV
26537
US

IV. Provider business mailing address

430 MORGANTOWN STREET
KINGWOOD WV
26537
US

V. Phone/Fax

Practice location:
  • Phone: 304-864-6915
  • Fax: 604-864-6917
Mailing address:
  • Phone: 304-864-6915
  • Fax: 304-864-6917

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1223G0001X
TaxonomyGeneral Practice Dentistry
License Number3835
License Number StateWV

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: