Kanawha Citiy Pediatric Dentistry | |
4502 Maccorkle Ave Se Suite C Charleston WV 25304-1835 | |
(304) 926-9260 | |
(304) 926-9266 |
Full Name | Kanawha Citiy Pediatric Dentistry |
---|---|
Speciality | Dentist - Pediatric Dentistry |
Location | 4502 Maccorkle Ave Se, Charleston, West Virginia |
Authorized Official Name and Position | Don E Skaff (OWNER) |
Authorized Official Contact | 3049269260 |
Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
Mailing Address | Practice Location Address |
---|---|
Kanawha Citiy Pediatric Dentistry 4502 Maccorkle Ave Se Suite C Charleston WV 25304-1835 Ph: (304) 926-9260 | Kanawha Citiy Pediatric Dentistry 4502 Maccorkle Ave Se Suite C Charleston WV 25304-1835 Ph: (304) 926-9260 |
NPI Number | 1740621036 |
---|---|
Provider Enumeration Date | 07/15/2013 |
Last Update Date | 07/15/2013 |
Identifier | Type | State | Issuer |
---|---|---|---|
1740621036 | NPI | - | NPPES |
0138545000 | Medicaid | WV |
Taxonomy | Type | License (State) | Status |
---|---|---|---|
1223P0221X | Dentist - Pediatric Dentistry | 2869 (West Virginia) | Primary |
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