Provider Demographics
NPI:1821648080
Name:KYLE HUISH DDS PLLC
Entity Type:Organization
Organization Name:KYLE HUISH DDS PLLC
Other - Org Name:DYNAMIC DENTAL CARE
Other - Org Type:Doing Business As
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:KYLE
Authorized Official - Middle Name:
Authorized Official - Last Name:HUISH
Authorized Official - Suffix:
Authorized Official - Credentials:DDS
Authorized Official - Phone:602-616-1562
Mailing Address - Street 1:6107 HILLMONT LN
Mailing Address - Street 2:
Mailing Address - City:SPOKANE
Mailing Address - State:WA
Mailing Address - Zip Code:99217-8771
Mailing Address - Country:US
Mailing Address - Phone:602-616-1562
Mailing Address - Fax:
Practice Address - Street 1:10010 N DIVISION ST
Practice Address - Street 2:
Practice Address - City:SPOKANE
Practice Address - State:WA
Practice Address - Zip Code:99218-1305
Practice Address - Country:US
Practice Address - Phone:509-466-2587
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2019-09-18
Last Update Date:2019-10-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QD0000XAmbulatory Health Care FacilitiesClinic/CenterDental
Provider Identifiers
StateIdentifier IDID TypeIssuer
WA0405124OtherDEPT OF LABOR AND INDUSTRIES