Provider Demographics
NPI:1982073466
Name:KYLE GARLITZ DDS LLC
Entity Type:Organization
Organization Name:KYLE GARLITZ DDS LLC
Other - Org Name:GARLITZ COSMETIC & FAMILY DENTISTRY
Other - Org Type:Doing Business As
Authorized Official - Title/Position:DENTIST/OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:KYLE
Authorized Official - Middle Name:
Authorized Official - Last Name:GARLITZ
Authorized Official - Suffix:
Authorized Official - Credentials:DDS
Authorized Official - Phone:704-577-4287
Mailing Address - Street 1:5 LAKE CAROLINA WAY
Mailing Address - Street 2:SUITE 210
Mailing Address - City:COLUMBIA
Mailing Address - State:SC
Mailing Address - Zip Code:29229-7561
Mailing Address - Country:US
Mailing Address - Phone:803-736-8606
Mailing Address - Fax:803-736-8696
Practice Address - Street 1:105 SALUDA POINTE CT
Practice Address - Street 2:STE C
Practice Address - City:LEXINGTON
Practice Address - State:SC
Practice Address - Zip Code:29072
Practice Address - Country:US
Practice Address - Phone:803-609-9212
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2015-09-15
Last Update Date:2015-09-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1223G0001XDental ProvidersDentistGeneral PracticeGroup - Single Specialty