# ROBERSON FAMILY DENTAL, INC

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- **Entity:** Organization
- **Status:** Active
- **Organization subpart:** No

## Provider details

- **NPI number:** 1881347235
- **Authorized official:** DR. KENNETH JAMES ROBERSON DDS (OWNER/PRESIDENT)
- **Authorized official phone:** (304) 539-0876

## Contact information

- **Practice address:** 324 29TH ST, HUNTINGTON, WV 25702-1428
- **Practice address phone:** (304) 523-2790
- **Mailing address:** 324 29TH ST, HUNTINGTON, WV 25702-1428
- **Mailing address phone:** (304) 523-2790

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 122300000X | Dentist | — | — | Yes |

## Other

- **Enumeration date:** 01/26/2022
- **Last updated:** 01/26/2022

## Other identifiers

| Code | Description | Identifier | Issuer | State |
| --- | --- | --- | --- | --- |
| 01 | — | 4276 | WV BOARD OF DENTISTRY | WV |