Provider Demographics
NPI:1255535225
Name:KYLE E FARLEY DDS PC
Entity type:Organization
Organization Name:KYLE E FARLEY DDS PC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:KYLE
Authorized Official - Middle Name:EDWIN
Authorized Official - Last Name:FARLEY
Authorized Official - Suffix:
Authorized Official - Credentials:DDS
Authorized Official - Phone:801-225-0471
Mailing Address - Street 1:390 W 920 N
Mailing Address - Street 2:
Mailing Address - City:OREM
Mailing Address - State:UT
Mailing Address - Zip Code:84057-3042
Mailing Address - Country:US
Mailing Address - Phone:801-225-0471
Mailing Address - Fax:801-225-4461
Practice Address - Street 1:390 W 920 N
Practice Address - Street 2:
Practice Address - City:OREM
Practice Address - State:UT
Practice Address - Zip Code:84057-3042
Practice Address - Country:US
Practice Address - Phone:801-225-0471
Practice Address - Fax:801-225-4461
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-06-13
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1223G0001XDental ProvidersDentistGeneral PracticeGroup - Single Specialty