| NPI | 1780893909 |
|---|---|
| Former Legal Business Name | KENNETH H DOLAN DMD LTD |
| Entity Type | Organization |
| Authorized Contact | KENNETH H DOLAN President Treasurer 304-345-4960 |
| Organization Subpart ? | No |
| Primary Taxonomy | 122300000X Dentist (Licence: WV 2275) |
| Additional Taxonomies | 122300000X Dentist (Licence: WV 3209) |
| 1223X0400X Dentist, Orthodontics and Dentofacial Orthopedics (Licence: WV 60) | |
| 1223X0400X Dentist, Orthodontics and Dentofacial Orthopedics (Licence: WV 101) | |
| Enumeration Date | 2007-05-22 |
| Last Update Date | 2020-08-22 |