Organization
ROBERSON FAMILY DENTAL, INC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. KENNETH JAMES ROBERSON DDS (OWNER/PRESIDENT)
(304) 539-0876
Entity
Organization
Contact information
Practice address
324 29TH ST, HUNTINGTON, WV 25702-1428
(304) 523-2790
Mailing address
324 29TH ST, HUNTINGTON, WV 25702-1428
(304) 523-2790
Taxonomy
Speciality
Code
Description
License number
State
122300000X
Dentist
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
4276
WV BOARD OF DENTISTRY
WV
Enumeration date
01/26/2022
Last updated
01/26/2022
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