Provider Demographics
NPI:1205131380
Name:HARMON, KYLE KEITH (DDS)
Entity type:Individual
Prefix:DR
First Name:KYLE
Middle Name:KEITH
Last Name:HARMON
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 1:360 S FORT LN
Mailing Address - Street 2:SUITE B-100
Mailing Address - City:LAYTON
Mailing Address - State:UT
Mailing Address - Zip Code:84041-4259
Mailing Address - Country:US
Mailing Address - Phone:801-544-9777
Mailing Address - Fax:
Practice Address - Street 1:360 S FORT LN
Practice Address - Street 2:SUITE B-100
Practice Address - City:LAYTON
Practice Address - State:UT
Practice Address - Zip Code:84041-4259
Practice Address - Country:US
Practice Address - Phone:801-544-9777
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2011-01-20
Last Update Date:2011-01-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
UT7697803-99221223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice