Individual
DR. MATTHEW BROOKS KERNER
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
D.M.D
Contact information
Practice address
803 PENNSYLVANIA AVE, STE 302, CHARLESTON, WV 25302
(304) 388-2950
(304) 388-2951
Mailing address
200 MORRIS ST, #107, CHARLESTON, WV 25301-1821
(304) 344-2220
(304) 388-2951
Taxonomy
Speciality
Code
Description
License number
State
122300000X
Dentist
Primary
0160002193
VT
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
0160002193
STATE LICENSE
VT
05
—
1010666
—
VT
05
—
3810009544
—
WV
Enumeration date
10/04/2006
Last updated
11/15/2007
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