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General NPI Number Information
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NPI Number | 1013130251
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Entity Type | Organization
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Legal Business Name | MICHAEL J HEDMOND DDS PLLC
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Dates
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Enumeration Date | 04/10/2007
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Last Update Date | 06/18/2008
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Provider Practice Location Address
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Address Line | 332 PENCO RD
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City | WEIRTON
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State | WV
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Zip | 26062-3813
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Country | US
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Telephone | 304-723-1230
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Fax |
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Provider Business Mailing Address
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Address Line | 332 PENCO RD
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City | WEIRTON
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State | WV
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Zip | 26062-3813
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Country | US
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Telephone | 304-723-1230
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Fax |
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Authorized Official
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Title or Position | SOLE MEMBER
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Name | MICHAEL HEDMOND
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Credential | DDS
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Telephone | 304-723-1230
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 122300000X
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Taxonomy Name | Dentist
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License Number | 2713
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License Number State | WV
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