Christopher J Rodebaugh, DDS Inc
Organization Active NPI General Practice Dentistry · Ronceverte, WV
NPI 1043658503 · NPPES record last updated Jun 6, 2013
Key facts
- NPI
- 1043658503
- Entity type
- Organization (NPI type 2)
- Primary specialty
- General Practice Dentistry 1223G0001X
- License
- 3820 (WV)
- Legal business name
- CHRISTOPHER J RODEBAUGH, DDS INC
- Practice address
- 120 Maplewood Ave
Ronceverte, WV 24970-9736 - Phone
- (304) 645-3110
- Fax
- (304) 645-3209
- NPI assigned
- Jun 6, 2013
- Organization subpart
- No
Authorized official
- Name
- Dr. Christopher J Rodebaugh
- Title
- Dentist
- Phone
- (304) 645-3110
Corporate family (same tax ID) 1
Practitioners 1
-
Richard Marshall Jr., DDS
National Provider Directory
- Tax ID family
- Christopher J Rodebaugh DDS Inc
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| General Practice Dentistry |
1223G0001X | 3820 | WV | Yes |
Addresses
Primary practice location
120 Maplewood Ave
Ronceverte, WV 24970-9736
Mailing address
120 Maplewood Ave
Ronceverte, WV 24970-9736
Phone (304) 645-3110
Other identifiers
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 38100178725 | Medicaid | WV |
Other providers in Ronceverte, WV
- John Casto
- Janice Centa
- Samantha L Chaffin
- Charleston Area Medical Center, Inc.
- Jo Ann Chestnut
- Ralph A Church
- Heather Marie Clawges
- Jessica Cochran
- Jeffrey Coleman
- Misty Rose Comer
All providers in Ronceverte, WV · General Practice Dentistry in West Virginia
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Jun 6, 2013. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.