Individual
DR. ROBERT DWAYNE KILGORE
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
DMD
Contact information
Practice address
106 WATER STREET, WISE, VA 24293
(276) 328-5291
(276) 328-2539
Mailing address
PO BOX 3937, 106 WATER STREET, WISE, VA 24293-3937
(276) 328-5291
(276) 328-2539
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
6902
VA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
102614
UNITED CONCORDIA
VA
01
—
281624
ANTHEM
VA
Enumeration date
07/13/2006
Last updated
07/08/2007
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