Provider Demographics
NPI:1922038793
Name:HOTCHKISS, LYLE EDWARD (DDS)
Entity Type:Individual
Prefix:DR
First Name:LYLE
Middle Name:EDWARD
Last Name:HOTCHKISS
Suffix:
Gender:M
Credentials:DDS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1648 PERIWINKLE WAY
Mailing Address - Street 2:SUITE C-1
Mailing Address - City:SANIBEL
Mailing Address - State:FL
Mailing Address - Zip Code:33957-4406
Mailing Address - Country:US
Mailing Address - Phone:239-395-1211
Mailing Address - Fax:
Practice Address - Street 1:1648 PERIWINKLE WAY
Practice Address - Street 2:SUITE C-1
Practice Address - City:SANIBEL
Practice Address - State:FL
Practice Address - Zip Code:33957-4406
Practice Address - Country:US
Practice Address - Phone:239-395-1211
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2006-07-04
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLD14314122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist