Provider Demographics
NPI:1568774586
Name:WINTER, KYLE PATRICK (DDS)
Entity Type:Individual
Prefix:DR
First Name:KYLE
Middle Name:PATRICK
Last Name:WINTER
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 1:101 4TH ST NW
Mailing Address - Street 2:
Mailing Address - City:BUFFALO CENTER
Mailing Address - State:IA
Mailing Address - Zip Code:50424-1055
Mailing Address - Country:US
Mailing Address - Phone:641-562-2297
Mailing Address - Fax:641-562-2267
Practice Address - Street 1:101 4TH ST NW
Practice Address - Street 2:
Practice Address - City:BUFFALO CENTER
Practice Address - State:IA
Practice Address - Zip Code:50424-1055
Practice Address - Country:US
Practice Address - Phone:641-562-2297
Practice Address - Fax:641-562-2267
Is Sole Proprietor?:No
Enumeration Date:2010-07-07
Last Update Date:2010-07-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IA087441223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice