Provider Demographics
NPI:1689073660
Name:RICHARD GREGORY PYLE DDS PC
Entity Type:Organization
Organization Name:RICHARD GREGORY PYLE DDS PC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:RICHARD
Authorized Official - Middle Name:GREGORY
Authorized Official - Last Name:PYLE
Authorized Official - Suffix:
Authorized Official - Credentials:DDS
Authorized Official - Phone:765-288-6121
Mailing Address - Street 1:800 W UNIVERSITY AVE
Mailing Address - Street 2:
Mailing Address - City:MUNCIE
Mailing Address - State:IN
Mailing Address - Zip Code:47303-3863
Mailing Address - Country:US
Mailing Address - Phone:765-288-6121
Mailing Address - Fax:765-282-8706
Practice Address - Street 1:800 W UNIVERSITY AVE
Practice Address - Street 2:
Practice Address - City:MUNCIE
Practice Address - State:IN
Practice Address - Zip Code:47303-3863
Practice Address - Country:US
Practice Address - Phone:765-288-6121
Practice Address - Fax:765-282-8706
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2014-08-15
Last Update Date:2014-10-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IN12009262122300000X, 332BC3200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes122300000XDental ProvidersDentistGroup - Single Specialty
No332BC3200XSuppliersDurable Medical Equipment & Medical SuppliesCustomized EquipmentGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
IN7204350001Medicare NSC