Spain, Lon Patrick
Spain, Lon Patrick is an individual health care provider with primary practice located at 408 Alexander Street , Cedar Grove WV 25039. He recently has only one registered license in Dental Providers / Dentist, which is considered as his primary health care specialty. Spain, Lon Patrick can be contacted via phone (304) 595-1770.Contact Information
Primary practice address
408 Alexander Street
Cedar Grove WV 25039
Phone: (304) 595-1770
Fax:
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Dental Providers / Dentist | 122300000X | 3400 | West Virginia |
Profile Details
| NPI number | 1891765822 |
|---|---|
| LBN Legal business name | Spain, Lon Patrick |
| Credentials | Doctor of Dental Surgery (DDS) |
| Entity | Individual |
| Sole proprietor 1 | No |
| Enumeration date | Jan 24th, 2006 |
| Last updated | Sep 17th, 2013 - about 12 years ago |
1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.
Identifiers
| State | Type | Number | Issuer |
|---|---|---|---|
| All States | NPI | 1891765822 | NPPES |
| Kentucky | MEDICAID | 7100174300 | |
| Kentucky | MEDICAID | 2036862 | |
| Kentucky | MEDICAID | 7805006000 |
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