Individual
DR. STANLEY WARREN KACZKOWSKI
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
DDS
Contact information
Practice address
5376 BIG TYLER RD, CROSS LANES, WV 25313-1059
(304) 776-2223
(304) 776-2225
Mailing address
5376 BIG TYLER RD, CROSS LANES, WV 25313-1059
(304) 776-2223
(304) 776-2225
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
WV2189
WV
Other
Enumeration date
09/22/2006
Last updated
07/08/2007
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