OrganizationActive
Stan Kaczkowski DDS PLLC
NPI 1366053324 · Dental Clinic/Center · Cross Lanes, WV
Provider details
- NPI number
- 1366053324
- Entity type
- Organization
- Primary specialty
- Dental Clinic/CenterAmbulatory Health Care Facilities
- Organization subpart
- No
- Authorized official
- Stan Kaczkowski, Owner/Dentist(304) 776-2223
Specialties & taxonomies
Ambulatory Health Care Facilities
Practice location
5376 Big Tyler Rd
Cross Lanes, WV 25313-1059
Phone: (304) 776-2223
Approximate (ZIP-level) locationGet directions
Mailing address
5376 Big Tyler Rd
Cross Lanes, WV 25313-1059
Registry dates
- Enumerated
- 2020-08-13
- Last updated
- 2020-08-13
- Certified
- 2020-08-13
Source: CMS NPPES Data Dissemination (June 2026). NPI Central is not affiliated with CMS. Data is provided as-is from the public registry.