Provider Demographics
NPI:1982765566
Name:KIRKLAND, KYLE WILLIAM (DDS)
Entity Type:Individual
Prefix:DR
First Name:KYLE
Middle Name:WILLIAM
Last Name:KIRKLAND
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 1:2600 COGGIN AVE
Mailing Address - Street 2:
Mailing Address - City:BROWNWOOD
Mailing Address - State:TX
Mailing Address - Zip Code:76801-5380
Mailing Address - Country:US
Mailing Address - Phone:325-643-4622
Mailing Address - Fax:325-643-4584
Practice Address - Street 1:2600 COGGIN AVE
Practice Address - Street 2:
Practice Address - City:BROWNWOOD
Practice Address - State:TX
Practice Address - Zip Code:76801-5380
Practice Address - Country:US
Practice Address - Phone:325-643-4622
Practice Address - Fax:325-643-4584
Is Sole Proprietor?:Yes
Enumeration Date:2006-12-13
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX1223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice