Provider Demographics
NPI:1033987201
Name:KYLE VILORIA DMD PLLC
Entity Type:Organization
Organization Name:KYLE VILORIA DMD PLLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:MEMBER
Authorized Official - Prefix:DR
Authorized Official - First Name:KYLE LESTER
Authorized Official - Middle Name:PABUSTAN
Authorized Official - Last Name:VILORIA
Authorized Official - Suffix:
Authorized Official - Credentials:DMD
Authorized Official - Phone:757-575-4147
Mailing Address - Street 1:12511 CEDAR POST LN
Mailing Address - Street 2:
Mailing Address - City:CHARLOTTE
Mailing Address - State:NC
Mailing Address - Zip Code:28215-9039
Mailing Address - Country:US
Mailing Address - Phone:757-575-4147
Mailing Address - Fax:
Practice Address - Street 1:5350 DOCIA CROSSING RD STE 5346C
Practice Address - Street 2:
Practice Address - City:CHARLOTTE
Practice Address - State:NC
Practice Address - Zip Code:28269-4262
Practice Address - Country:US
Practice Address - Phone:980-275-5445
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2023-12-18
Last Update Date:2023-12-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes122300000XDental ProvidersDentistGroup - Single Specialty