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General NPI Number Information
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NPI Number | 1215458864
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Entity Type | Organization
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Legal Business Name | JOHN W BYERS, DDS, PLLC
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Dates
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Enumeration Date | 07/05/2017
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Last Update Date | 07/05/2017
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Provider Practice Location Address
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Address Line | 122 YATES AVE
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City | GRAFTON
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State | WV
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Zip | 26354
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Country | US
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Telephone | 304-265-2438
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Fax | 304-265-1545
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Provider Business Mailing Address
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Address Line | 122 YATES AVE
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City | GRAFTON
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State | WV
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Zip | 26354
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Country | US
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Telephone | 304-265-2438
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Fax | 304-265-1545
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Authorized Official
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Title or Position | OWNER
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Name | MR. JOHN WILLIAM BYERS
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Credential | DDS
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Telephone | 304-265-2438
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 125K00000X
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Taxonomy Name | Advanced Practice Dental Therapist
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License Number | 12507
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License Number State | WV
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