Austin, Krystin Bourdua
Austin, Krystin Bourdua is an individual health care provider with primary practice located at 3997 Beckley Rd , Princeton WV 24740-7660. She recently has only one registered license in Dental Providers / General Practice, which is considered as her primary health care specialty. Austin, Krystin Bourdua can be contacted via phone (304) 425-4585.Contact Information
Primary practice address
3997 Beckley Rd
Princeton WV 24740-7660
Phone: (304) 425-4585
Fax: (304) 431-3400
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Dental Providers / General Practice | 1223G0001X | 4265 | West Virginia |
Profile Details
| NPI number | 1407385735 |
|---|---|
| LBN Legal business name | Austin, Krystin Bourdua |
| Credentials | Doctor of Dental Surgery (DDS) |
| Entity | Individual |
| Sole proprietor 1 | No |
| Enumeration date | Jun 9th, 2017 |
| Last updated | Jan 25th, 2019 - about 7 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 | 1407385735 | NPPES |
| West Virginia | MEDICAID | 1407385735 |
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