Provider Demographics
NPI:1285080549
Name:ANDREW MINIGH DDS OF GLENVILLE INC
Entity type:Organization
Organization Name:ANDREW MINIGH DDS OF GLENVILLE INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:ANDREW
Authorized Official - Middle Name:
Authorized Official - Last Name:MINIGH
Authorized Official - Suffix:
Authorized Official - Credentials:DDS
Authorized Official - Phone:304-592-0600
Mailing Address - Street 1:PO BOX 730
Mailing Address - Street 2:
Mailing Address - City:GLENVILLE
Mailing Address - State:WV
Mailing Address - Zip Code:26351-0730
Mailing Address - Country:US
Mailing Address - Phone:304-462-7343
Mailing Address - Fax:
Practice Address - Street 1:809 MINERAL RD
Practice Address - Street 2:
Practice Address - City:GLENVILLE
Practice Address - State:WV
Practice Address - Zip Code:26351-1385
Practice Address - Country:US
Practice Address - Phone:304-462-7343
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2016-05-05
Last Update Date:2016-05-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WV38191223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1223G0001XDental ProvidersDentistGeneral PracticeGroup - Single Specialty