Provider records sourced from NPPES (CMS National Plan & Provider Enumeration System). Data current as of August 10, 2026.

Drs Brock, Henderson, Di Prisco, Ravelo and Green Inc

Organization Oral and Maxillofacial Surgery (Dentist) · NPI 1194364398

Drs Brock, Henderson, Di Prisco, Ravelo and Green Inc is an Oral and Maxillofacial Surgery (Dentist) in Beckley, West Virginia. Registered with an NPI since 2020.

In the registry since
2020
What do these letters mean?
Inc — Incorporated
A form of business registration, not a clinical qualification.

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Practice location Address checks out

433 Carriage Dr
Beckley, WV 25801-2805
Phone: (304) 256-3777
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Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Oral and Maxillofacial Surgery (Dentist) (primary) Taxonomy 1223S0112X

Record details

NPI number1194364398
Entity typeOrganization (Type 2)
Organization subpartNo
Authorized official Lesley Coyner — Credentialing · (304) 345-1092
NPI enumeratedJanuary 6, 2020
Last updated in NPPESMay 29, 2025
Certification dateMay 29, 2025
Mailing address103 Station Place Way, Hurricane, WV 25526-8747

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