Provider Demographics
NPI:1821228875
Name:AARON, KYLE EUGENE (D,D,S,)
Entity Type:Individual
Prefix:DR
First Name:KYLE
Middle Name:EUGENE
Last Name:AARON
Suffix:
Gender:M
Credentials:D,D,S,
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2095 W MAIN ST
Mailing Address - Street 2:STE A
Mailing Address - City:LEAGUE CITY
Mailing Address - State:TX
Mailing Address - Zip Code:77573-3581
Mailing Address - Country:US
Mailing Address - Phone:281-332-1919
Mailing Address - Fax:281-554-7525
Practice Address - Street 1:2095 W MAIN ST
Practice Address - Street 2:STE A
Practice Address - City:LEAGUE CITY
Practice Address - State:TX
Practice Address - Zip Code:77573-3581
Practice Address - Country:US
Practice Address - Phone:281-332-1919
Practice Address - Fax:281-554-7525
Is Sole Proprietor?:No
Enumeration Date:2009-07-23
Last Update Date:2009-07-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX0024879122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist