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Organization
KEVIN C. LUCKY DDS PLLC
Active
Organization
KEVIN C. LUCKY DDS PLLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. KEVIN CHARLIE LUCKY DDS (OWNER)
(304) 872-3919
Entity
Organization
Contact information
Practice address
1110 JOHNSTOWN ROAD, BECKLEY, WV 25801
(304) 255-0717
(304) 255-0956
Mailing address
832 BROAD STREET, SUMMERSVILLE, WV 26651
(304) 872-3919
(304) 872-4043
Taxonomy
Speciality
Code
Description
License number
State
261QD0000X
Dental Clinic/Center
Primary
—
NULL
Other
Enumeration date
03/28/2007
Last updated
08/22/2020
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