Healthcare Provider Details

I. General information

NPI: 1770828535
Provider Name (Legal Business Name): MARY PALMER GIOIA DDS
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 12/05/2012
Last Update Date: 12/05/2012
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1994 LUMBER AVE
WHEELING WV
26003-5371
US

IV. Provider business mailing address

1994 LUMBER AVE
WHEELING WV
26003-5371
US

V. Phone/Fax

Practice location:
  • Phone: 304-242-8959
  • Fax: 304-242-8950
Mailing address:
  • Phone: 304-242-8959
  • Fax: 304-242-8950

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code122300000X
TaxonomyDentist
License NumberWV2985
License Number StateWV
# 2
Primary TaxonomyN
Taxonomy Code122300000X
TaxonomyDentist
License Number19091
License Number StateOH

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: