Provider Demographics
NPI:1427577972
Name:JEFFREY M KYES DMD
Entity Type:Organization
Organization Name:JEFFREY M KYES DMD
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:JEFFREY
Authorized Official - Middle Name:M
Authorized Official - Last Name:KYES
Authorized Official - Suffix:
Authorized Official - Credentials:DMD
Authorized Official - Phone:207-794-6577
Mailing Address - Street 1:PO BOX 26
Mailing Address - Street 2:
Mailing Address - City:LINCOLN
Mailing Address - State:ME
Mailing Address - Zip Code:04457-0026
Mailing Address - Country:US
Mailing Address - Phone:207-794-6577
Mailing Address - Fax:207-794-8383
Practice Address - Street 1:168 W BROADWAY
Practice Address - Street 2:
Practice Address - City:LINCOLN
Practice Address - State:ME
Practice Address - Zip Code:04457-4003
Practice Address - Country:US
Practice Address - Phone:207-794-6577
Practice Address - Fax:207-794-8383
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2017-09-15
Last Update Date:2017-09-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
ME2931332B00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes332B00000XSuppliersDurable Medical Equipment & Medical Supplies