Arlie Britton Dolly III, DDS
Individual provider Active NPI General Practice Dentistry · Capan Bridge, WV
NPI 1124130216 · NPPES record last updated Jan 31, 2008
Key facts
- NPI
- 1124130216
- Entity type
- Individual (NPI type 1)
- Primary specialty
- General Practice Dentistry 1223G0001X
- License
- 3394 (WV)
- Practice address
- HC 61 Box 303
Capan Bridge, WV 26711 - Phone
- (304) 856-3200
- Fax
- (304) 856-3213
- NPI assigned
- Aug 31, 2006
- Sex
- Male
- Sole proprietor
- No
Medicare participation
- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
- Medicare enrollment (NPD)
- No
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 3394 | WV | MD | Family Medicine Physician |
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| General Practice Dentistry | 1223G0001X | 3394 | WV | Yes |
Addresses
Primary practice location
HC 61 Box 303
Capan Bridge, WV 26711
Mailing address
HC 61 Box 303
Capan Bridge, WV 26711
Phone (304) 856-3200
Other identifiers
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 0134691000 | Medicaid | WV |
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Jan 31, 2008. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.