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Kevin C. Lucky Dds Pllc
Dental Clinic/Center in Beckley, West Virginia
NPI 1235258757

Kevin C. Lucky Dds Pllc is a Dental Clinic/Center based in Summersville, WV and is specialized in Dental. Kevin C. Lucky Dds Pllc practices in Beckley, WV. The NPI Number for Kevin C. Lucky Dds Pllc is 1235258757 and holds a License No. (West Virginia).

The current practice location address for Kevin C. Lucky Dds Pllc is 1110 Johnstown Road, Beckley, WV and can be reached out via phone at 304-255-0717 and via fax at 304-255-0956.

Location: 1110 Johnstown Road, Beckley, WV, 26651
Profile Details Legacy Identifiers Practice Address Mailing Address Primary Taxonomy
institution
Provider Profile Details
NPI Number
1235258757
Provider Name
Kevin C. Lucky Dds Pllc
Credential
Provider Entity Type
Organization
Address
1110 Johnstown Road, Beckley, WV, 26651
Phone Number
304-255-0717
Fax Number
304-255-0956
Provider Enumeration Date
03/28/2007
Last Update Date
03/09/2024
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Provider's Legacy Identifiers
Identifier Type State Issuer
1104970300 01 INDV. NPI
3810007754 05 WV
institution
Provider Business Practice Location Address Details
Address
1110 Johnstown Road
City
Beckley
State
West Virginia
Zip
25801
Phone Number
304-255-0717
Fax Number
304-255-0956
person
Provider Business Mailing Address Details
Address
1110 Johnstown Road
City
Beckley
State
West Virginia
Zip
25801
Phone Number
304-255-0717
Fax Number
304-255-0956
person
Provider's Taxonomy Details 1
Type
Ambulatory Health Care Facilities
Classification
Clinic/Center
Speciality
Dental
Taxonomy
261QD0000X
License No.
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Definition
Definition to come...
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