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 1346201183

Drs Brock, Henderson, Di Prisco, Ravelo and Green Inc is an Oral and Maxillofacial Surgery (Dentist) in Charleston, West Virginia. Registered with an NPI since 2006.

In the registry since
2006
What do these letters mean?
Inc — Incorporated
A form of business registration, not a clinical qualification.

See every abbreviation used in this directory →

Practice location Address checks out

1215 Virginia St E
Charleston, WV 25301
Phone: (304) 345-1092
Fax: (304) 345-5080
Show map & directions

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 number1346201183
Entity typeOrganization (Type 2)
Organization subpartNo
Authorized official Lesley Coyner — Credentialing · (304) 720-7819
Other names Mt State Oral & Maxillofacial Surgeons; Mt State Oral & Maxillofacial Surgeons
NPI enumeratedMarch 31, 2006
Last updated in NPPESMay 29, 2025
Certification dateMay 29, 2025
Mailing address103 Station Place Way, Hurricane, WV 25526-8747

Other providers in Charleston