| Kanawha County Dental Health Council Inc | |
|
1900 School St Kdhc Charleston WV 25312 | |
| (304) 348-6613 | |
| Not Available |
| Full Name | Kanawha County Dental Health Council Inc |
|---|---|
| Speciality | Clinic/center - Dental |
| Location | 1900 School St, Charleston, West Virginia |
| Authorized Official Name and Position | Lisa Anne Moore (EXECUTIVE DIRECTOR) |
| Authorized Official Contact | 3043486613 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Kanawha County Dental Health Council Inc 1900 School St Kanawha Dental Health Council Inc Charleston WV 25312 Ph: (304) 348-6613 | Kanawha County Dental Health Council Inc 1900 School St Kdhc Charleston WV 25312 Ph: (304) 348-6613 |
| NPI Number | 1770615122 |
|---|---|
| Provider Enumeration Date | 03/12/2007 |
| Last Update Date | 08/22/2020 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1770615122 | NPI | - | NPPES |
| 0012835000 | Medicaid | WV |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261QD0000X | Clinic/center - Dental | (* (Not Available)) | Primary |
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