Stan Kaczkowski DDS Pllc

NPI #1366053324 in Cross Lanes, West Virginia

Provider Information

NPI Number
1366053324
Entity Type
Organization
Organization Name
Stan Kaczkowski DDS Pllc
Primary Specialty
Clinic/Center - Dental
Enumeration Date
Aug 13, 2020
Last Updated
Aug 13, 2020

Practice Location

Address
5376 BIG TYLER RD
ZIP Code
25313-1059
Phone
(304) 776-2223

Authorized Official

Name
DR. STAN WARREN KACZKOWSKI, DDS
Title
OWNER/DENTIST
Phone
(304) 776-2223

Specialties & Taxonomy Codes

Specialty
Clinic/Center - DentalDental

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