Individual
MARK KINGSTON
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
DDS
Contact information
Practice address
1 MEDICAL CENTER DR, MORGANTOWN, WV 26506
(304) 293-5251
Mailing address
PO BOX 9400, MORGANTOWN, WV 26506-9400
(304) 293-5251
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
2017002808
MO
390200000X
Student in an Organized Health Care Education/Training Program
—
WV
Other
Enumeration date
06/14/2016
Last updated
01/23/2020
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