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5800 Willow Bend Rd Union WV 24983-6229 | |
| (304) 772-3707 | |
| Not Available |
| Full Name | |
|---|---|
| Speciality | Dentist - Orthodontics And Dentofacial Orthopedics |
| Location | 5800 Willow Bend Rd, Union, West Virginia |
| Authorized Official Name and Position | Donna Panucci (OWNER) |
| Authorized Official Contact | 3047723707 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
5800 Willow Bend Rd Union WV 24983-6229 Ph: (304) 772-3707 | 5800 Willow Bend Rd Union WV 24983-6229 Ph: (304) 772-3707 |
| NPI Number | 1932688512 |
|---|---|
| Provider Enumeration Date | 08/14/2018 |
| Last Update Date | 08/14/2018 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1932688512 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 1223X0400X | Dentist - Orthodontics And Dentofacial Orthopedics | 3174 (West Virginia) | Primary |
Katherine L Kilcollin, Dds Pllc Dental Clinic Medicare: Not Enrolled in Medicare Practice Location: 247 Health Center Drive, Union, WV 24983 Phone: 304-772-3333 Fax: 304-772-3512 |