Individual
KENNETH H DOLAN
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
DMD
Contact information
Practice address
1217 VIRGINIA ST E, CHARLESTON, WV 25301
(304) 345-4960
(304) 345-4969
Mailing address
1217 VIRGINIA ST E, CHARLESTON, WV 25301
(304) 345-4960
(304) 345-4969
Taxonomy
Speciality
Code
Description
License number
State
122300000X
Dentist
2275
WV
1223X0400X
Orthodontics and Dentofacial Orthopedics Dentistry
Primary
60
WV
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
0137878000
—
WV
Enumeration date
11/07/2006
Last updated
12/06/2012
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