Kirk, Mark Alan

Kirk, Mark Alan is an individual health care provider with primary practice located at 308 East Main St , White Sulphur Springs WV 24986. He recently has only one registered license in Dental Providers / General Practice, which is considered as his primary health care specialty. Kirk, Mark Alan can be contacted via phone (304) 536-1721.

Contact Information

Primary practice address
308 East Main St White Sulphur Springs WV 24986
Phone: (304) 536-1721
Fax: (304) 536-1561
Website:
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Health care specialties

SpecialtyCodeLicense #State
Dental Providers / General Practice 1223G0001X 3137WV West Virginia

Profile Details

NPI number 1114094927
LBN Legal business name Kirk, Mark Alan
Credentials Doctor of Dental Surgery (DDS)
Entity Individual
Sole proprietor 1 No
Enumeration date Nov 29th, 2006
Last updated Jul 8th, 2007 - about 18 years ago

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

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Identifiers

StateTypeNumberIssuer
All States NPI 1114094927 NPPES
West Virginia MEDICAID 0133809000

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