Provider Demographics
NPI:1174721393
Name:MCBRIDE, KENT ALEXANDER (DDS, MS)
Entity type:Individual
Prefix:DR
First Name:KENT
Middle Name:ALEXANDER
Last Name:MCBRIDE
Suffix:
Gender:M
Credentials:DDS, MS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:9000 COOMBS FARM RD STE 304
Mailing Address - Street 2:
Mailing Address - City:MORGANTOWN
Mailing Address - State:WV
Mailing Address - Zip Code:26508-1150
Mailing Address - Country:US
Mailing Address - Phone:304-594-1670
Mailing Address - Fax:304-594-1671
Practice Address - Street 1:9000 COOMBS FARM RD STE 304
Practice Address - Street 2:
Practice Address - City:MORGANTOWN
Practice Address - State:WV
Practice Address - Zip Code:26508-1150
Practice Address - Country:US
Practice Address - Phone:304-594-1670
Practice Address - Fax:304-594-1671
Is Sole Proprietor?:Yes
Enumeration Date:2007-07-10
Last Update Date:2022-10-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MD149081223E0200X
PADS0366171223E0200X
WV36821223E0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223E0200XDental ProvidersDentistEndodontics