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General NPI Number Information
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NPI Number | 1922813377
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Entity Type | Organization
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Legal Business Name | JUSTICE FAMILY DENTISTRY PLLC
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Dates
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Enumeration Date | 02/12/2025
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Last Update Date | 02/12/2025
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Provider Practice Location Address
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Address Line | 45 E BENJAMIN DR
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City | NEW MARTINSVILLE
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State | WV
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Zip | 26155-2705
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Country | US
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Telephone | 304-455-5644
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Fax | 304-398-1344
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Provider Business Mailing Address
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Address Line | 45 E BENJAMIN DR
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City | NEW MARTINSVILLE
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State | WV
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Zip | 26155-2705
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Country | US
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Telephone | 304-455-5644
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Fax | 304-398-1344
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Authorized Official
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Title or Position | GENERAL DENTIST
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Name | DR. TABITHA LEIGH JUSTICE
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Credential | DDS
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Telephone | 304-893-1665
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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 |
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License Number State |
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