OrganizationActive
Drs Brock, Henderson, Di Prisco, Ravelo and Green Inc
NPI 1346201183 · Oral and Maxillofacial Surgery (Dentist) · Charleston, WV
Provider details
- NPI number
- 1346201183
- Entity type
- Organization
- Primary specialty
- Oral and Maxillofacial Surgery (Dentist)Dental Providers
- Authorized official
- Lesley Coyner, Credentialing
Practice location
1215 Virginia St E
Charleston, WV 25301
Phone: (304) 345-1092
Fax: (304) 345-5080
Mailing address
103 Station Place Way
Hurricane, WV 25526-8747
Registry dates
- Enumerated
- 2006-03-31
- Last updated
- 2025-05-29
Source: CMS NPPES Data Dissemination (June 2026). NPI Central is not affiliated with CMS. Data is provided as-is from the public registry.