Provider Demographics
NPI:1760824551
Name:WEST, HAROLD KENNETH III (DDS)
Entity Type:Individual
Prefix:DR
First Name:HAROLD
Middle Name:KENNETH
Last Name:WEST
Suffix:III
Gender:M
Credentials:DDS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4622 OLEANDER DR
Mailing Address - Street 2:
Mailing Address - City:WILMINGTON
Mailing Address - State:NC
Mailing Address - Zip Code:28403-5149
Mailing Address - Country:US
Mailing Address - Phone:910-399-1127
Mailing Address - Fax:
Practice Address - Street 1:4622 OLEANDER DR
Practice Address - Street 2:
Practice Address - City:WILMINGTON
Practice Address - State:NC
Practice Address - Zip Code:28403-5149
Practice Address - Country:US
Practice Address - Phone:910-399-1127
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2013-07-23
Last Update Date:2013-07-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC95891223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice