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General NPI Number Information
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NPI Number | 1285080549
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Entity Type | Organization
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Legal Business Name | ANDREW MINIGH DDS OF GLENVILLE INC
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Dates
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Enumeration Date | 05/05/2016
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Last Update Date | 05/05/2016
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Provider Practice Location Address
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Address Line | 809 MINERAL RD
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City | GLENVILLE
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State | WV
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Zip | 26351-1385
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Country | US
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Telephone | 304-462-7343
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Fax |
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Provider Business Mailing Address
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Address Line | PO BOX 730
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City | GLENVILLE
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State | WV
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Zip | 26351-0730
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Country | US
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Telephone | 304-462-7343
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Fax |
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Authorized Official
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Title or Position | PRESIDENT
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Name | DR. ANDREW MINIGH
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Credential | DDS
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Telephone | 304-592-0600
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 1223G0001X
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Taxonomy Name | General Practice Dentistry
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License Number | 3819
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License Number State | WV
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