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General NPI Number Information
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NPI Number | 1578688339
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Entity Type | Individual
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Provider Name | KENNETH LYON DDS
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Gender | Male
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Dates
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Enumeration Date | 03/20/2007
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Last Update Date | 11/17/2015
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Provider Practice Location Address
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Address Line | 2A MALL RD
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City | BARBOURSVILLE
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State | WV
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Zip | 25504-1821
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Country | US
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Telephone | 304-733-5500
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Fax |
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Provider Business Mailing Address
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Address Line | 5187 US RT 60 BLDG.3 STE7 EAST HILLS PROFESSIONAL CENTER
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City | HUNTINGTON
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State | WV
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Zip | 27504
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Country | US
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Telephone | 304-736-8620
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 122300000X
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Taxonomy Name | Dentist
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License Number | 2285
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License Number State | WV
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