Provider Demographics
NPI:1861663601
Name:KYLE L. BOBINET, D.D.S. PLC
Entity Type:Organization
Organization Name:KYLE L. BOBINET, D.D.S. PLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:DENTIST
Authorized Official - Prefix:DR
Authorized Official - First Name:KYLE
Authorized Official - Middle Name:L
Authorized Official - Last Name:BOBINET
Authorized Official - Suffix:
Authorized Official - Credentials:DDS
Authorized Official - Phone:641-732-3293
Mailing Address - Street 1:P.O. BOX 37
Mailing Address - Street 2:
Mailing Address - City:OSAGE
Mailing Address - State:IA
Mailing Address - Zip Code:50461
Mailing Address - Country:US
Mailing Address - Phone:641-732-3293
Mailing Address - Fax:641-732-3293
Practice Address - Street 1:132 MAIN STREET
Practice Address - Street 2:
Practice Address - City:OSAGE
Practice Address - State:IA
Practice Address - Zip Code:50461
Practice Address - Country:US
Practice Address - Phone:641-732-3293
Practice Address - Fax:641-732-3293
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-03-20
Last Update Date:2012-03-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IA076701223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1223G0001XDental ProvidersDentistGeneral PracticeGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
IA1099929Medicaid