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General NPI Number Information
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NPI Number | 1750580965
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Entity Type | Organization
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Legal Business Name | LORETTA J. GUNN
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Dates
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Enumeration Date | 07/17/2007
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Last Update Date | 07/17/2007
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Provider Practice Location Address
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Address Line | 911 HAL GREER BLVD
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City | HUNTINGTON
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State | WV
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Zip | 25701-3701
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Country | US
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Telephone | 304-523-1245
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Fax | 304-523-0217
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Provider Business Mailing Address
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Address Line | 911 HAL GREER BLVD
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City | HUNTINGTON
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State | WV
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Zip | 25701-3701
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Country | US
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Telephone | 304-523-1245
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Fax | 304-523-0217
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Authorized Official
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Title or Position | CO-OWNER OF DENTAL PRACTICE
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Name | DR. STEPHEN R GUNN
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Credential | D.D.S.
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Telephone | 304-523-1245
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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 |
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License Number State |
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