Provider Demographics
NPI:1639246697
Name:NOLTE, KAY (DDS)
Entity Type:Individual
Prefix:DR
First Name:KAY
Middle Name:
Last Name:NOLTE
Suffix:
Gender:F
Credentials:DDS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1530 FOREST LN S
Mailing Address - Street 2:SUITE H
Mailing Address - City:GARLAND
Mailing Address - State:TX
Mailing Address - Zip Code:75042-7950
Mailing Address - Country:US
Mailing Address - Phone:972-272-0673
Mailing Address - Fax:972-272-0674
Practice Address - Street 1:1530 FOREST LN S
Practice Address - Street 2:SUITE H
Practice Address - City:GARLAND
Practice Address - State:TX
Practice Address - Zip Code:75042-7950
Practice Address - Country:US
Practice Address - Phone:972-272-0673
Practice Address - Fax:972-272-0674
Is Sole Proprietor?:Yes
Enumeration Date:2006-11-28
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX142291223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice