Individual
NATHAN EARL KIRK II
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
DMD
Contact information
Practice address
3659 TEAYS VALLEY ROAD, HURRICANE, WV 25526-9701
(304) 201-8500
(304) 201-8505
Mailing address
PO BOX 581, HURRICANE, WV 25526-0581
(304) 201-8500
(304) 201-8505
Taxonomy
Speciality
Code
Description
License number
State
1223P0221X
Pediatric Dentistry
Primary
WV3568
WV
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
4002185000
—
WV
Enumeration date
01/31/2007
Last updated
07/08/2007
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