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General NPI Number Information
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NPI Number | 1912031105
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Entity Type | Organization
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Legal Business Name | IGNACIO Z. BERNARDO JR., D.D.S., INC.
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Dates
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Enumeration Date | 03/16/2007
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Last Update Date | 05/13/2024
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Provider Practice Location Address
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Address Line | 1021 QUARRIER ST SUITE 500
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City | CHARLESTON
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State | WV
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Zip | 25301
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Country | US
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Telephone | 304-346-0637
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Fax | 304-346-5137
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Provider Business Mailing Address
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Address Line | 1021 QUARRIER ST SUITE 500
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City | CHARLESTON
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State | WV
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Zip | 25301
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Country | US
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Telephone | 304-346-0637
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Fax | 304-346-5137
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Authorized Official
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Title or Position | DENTIST
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Name | DR. IGNACIO Z. BERNARDO JR.
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Credential |
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Telephone | 304-346-0637
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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 | 3257
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License Number State | WV
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