Organization
KIMBERLY T. LOUGH, DDS, MS, PLLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. KIMBERLY T LOUGH DDS, MS (PEDIATRIC DENTIST / OWNER)
(304) 722-7221
Entity
Organization
Contact information
Practice address
12 KANAWHA TER, SUITE B, ST ALBANS, WV 25177
(304) 722-7221
(304) 722-0420
Mailing address
12 KANAWHA TERRACE, SUITE B, ST ALBANS, WV 25177
(304) 722-7221
(304) 722-0420
Taxonomy
Speciality
Code
Description
License number
State
1223P0221X
Pediatric Dentistry
Primary
3415
WV
1223P0221X
Pediatric Dentistry
3783
WV
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
4004039000
—
WV
Enumeration date
07/25/2007
Last updated
06/13/2013
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