Provider Demographics
NPI:1346600376
Name:VILORIA, KYLE LESTER PABUSTAN (DDS)
Entity Type:Individual
Prefix:
First Name:KYLE LESTER
Middle Name:PABUSTAN
Last Name:VILORIA
Suffix:
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 1:9550 ROCKY RIVER RD STE 202
Mailing Address - Street 2:
Mailing Address - City:CHARLOTTE
Mailing Address - State:NC
Mailing Address - Zip Code:28215-9592
Mailing Address - Country:US
Mailing Address - Phone:704-496-9001
Mailing Address - Fax:855-254-9601
Practice Address - Street 1:9550 ROCKY RIVER RD STE 202
Practice Address - Street 2:
Practice Address - City:CHARLOTTE
Practice Address - State:NC
Practice Address - Zip Code:28215-9526
Practice Address - Country:US
Practice Address - Phone:704-496-9001
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2016-03-03
Last Update Date:2022-09-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC10442122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist