Individual
DR. KENNY H KOAY
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
DDS
Contact information
Practice address
17 OAKWOOD RD, FAIRMONT, WV 26554-2453
(304) 366-0411
Mailing address
17 OAKWOOD RD, FAIRMONT, WV 26554-2453
(304) 366-0411
Taxonomy
Speciality
Code
Description
License number
State
122300000X
Dentist
Primary
2881
WV
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
0132462000
—
WV
Enumeration date
09/27/2006
Last updated
07/08/2007
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