Kevin C. Lucky Dds Pllc in Summersville - Dental
Kevin C. Lucky Dds Pllc - NPI 1235258757
Kevin C. Lucky Dds Pllc is a Dental in Summersville, . Kevin C. Lucky Dds Pllc practices all healthcare services and medical treatments related to Dental. The NPI Number for Kevin C. Lucky Dds Pllc is 1235258757. The last update date is 2020-08-22.
Kevin C. Lucky Dds Pllc's current location address is 832 Broad Street, Summersville, . You can contact this provider via phone number 3048723919 and fax number 3048724043. The mailing address for Kevin C. Lucky Dds Pllc is 832 Broad Street, Summersville, . To know further, please read the information below!
Provider Profile Detail
| Provider Organization | Kevin C. Lucky Dds Pllc |
|---|---|
| Address | 832 Broad Street, Summersville, |
| Phone Number | 3048723919 |
| Fax Number | 3048724043 |
| Sole Proprietor | -- |
| Credentials | -- |
Authorized Official
| Title or Position | OWNER |
|---|---|
| Authorized Official Name | Lucky Charlie Kevin |
| Credentials | DDS |
| Telephone Number | 3048723919 |
NPI Number Detail
| NPI Number | 1235258757 |
|---|---|
| Provider Enumeration Date | 2007-03-28 |
| Last Updated Date | 2020-08-22 |
Provider Mailing Address Detail
| Address | 832 Broad Street |
|---|---|
| City | Summersville |
| State | (WV) |
| Post Code | 26651 |
| Phone Number | 3048723919 |
| Fax Number | 3048724043 |
Provider's Primary Taxonomy Detail
| Speciality | Dental |
|---|---|
| Taxonomy | 261Qd0000X |
|
Definition: Provides general and specialized dental care and oral surgery. |
|
Provider's Other Legacy Identifiers
| Identifier | Identifier Type | Identifier State | Identifier Issuer |
|---|---|---|---|
| 1104970300 | INDV. NPI | ||
| 3810007754 | WV | -- |
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What is the Kevin C. Lucky Dds Pllc's 1235258757?
The Kevin C. Lucky Dds Pllc's NPI (National Provider Identifier) Number is 1235258757. This unique 10-digit identification number is assigned to health care providers by the Centers for Medicare & Medicaid Services (CMS).
Could you share the physical location details of Kevin C. Lucky Dds Pllc?
The Kevin C. Lucky Dds Pllc is situated at 832 Broad Street, in the city of Summersville, state of WV, with the zip code 26651.
What is Kevin C. Lucky Dds Pllc's primary area of medical expertise, and what taxonomy classification code corresponds to this specialized field?
The primary area of medical expertise for Kevin C. Lucky Dds Pllc is Dental, and the corresponding taxonomy classification code for this specialized field is 261Qd0000X.
When was the Kevin C. Lucky Dds Pllc's 1235258757 issued?
The Kevin C. Lucky Dds Pllc's 1235258757 was issued on 2007-03-28.
When was the information pertaining to Kevin C. Lucky Dds Pllc most recently updated or revised?
The details related to Kevin C. Lucky Dds Pllc, including its address, specialty, and other relevant information, were last updated or revised on 2020-08-22.