Provider Demographics
NPI:1184743429
Name:KYLE, DAVID CHRISTIAN (DDS)
Entity type:Individual
Prefix:
First Name:DAVID
Middle Name:CHRISTIAN
Last Name:KYLE
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 1:2539 FOREST AVE
Mailing Address - Street 2:
Mailing Address - City:CHICO
Mailing Address - State:CA
Mailing Address - Zip Code:95928-7686
Mailing Address - Country:US
Mailing Address - Phone:530-342-6064
Mailing Address - Fax:530-342-0971
Practice Address - Street 1:2539 FOREST AVE
Practice Address - Street 2:
Practice Address - City:CHICO
Practice Address - State:CA
Practice Address - Zip Code:95928-7686
Practice Address - Country:US
Practice Address - Phone:530-342-6064
Practice Address - Fax:530-342-0971
Is Sole Proprietor?:Yes
Enumeration Date:2007-03-28
Last Update Date:2009-05-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA484901223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice