Provider Demographics
NPI:1760905335
Name:KYLE M. SMITH, D.D.S., P.A.
Entity Type:Organization
Organization Name:KYLE M. SMITH, D.D.S., P.A.
Other - Org Name:DENTAL SLEEP SOLUTIONS OF GREENVILLE
Other - Org Type:Other Name
Authorized Official - Title/Position:OWNER/DENTIST
Authorized Official - Prefix:DR
Authorized Official - First Name:KYLE
Authorized Official - Middle Name:M
Authorized Official - Last Name:SMITH
Authorized Official - Suffix:
Authorized Official - Credentials:DDS
Authorized Official - Phone:903-455-5750
Mailing Address - Street 1:4818 WELLINGTON ST STE 3
Mailing Address - Street 2:
Mailing Address - City:GREENVILLE
Mailing Address - State:TX
Mailing Address - Zip Code:75402-6010
Mailing Address - Country:US
Mailing Address - Phone:903-455-5750
Mailing Address - Fax:
Practice Address - Street 1:4818 WELLINGTON ST STE 3
Practice Address - Street 2:
Practice Address - City:GREENVILLE
Practice Address - State:TX
Practice Address - Zip Code:75402-6010
Practice Address - Country:US
Practice Address - Phone:903-455-5750
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2017-07-25
Last Update Date:2024-05-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1223G0001XDental ProvidersDentistGeneral PracticeGroup - Multi-Specialty
No332BC3200XSuppliersDurable Medical Equipment & Medical SuppliesCustomized Equipment