Provider Demographics
NPI:1629747498
Name:KYLE M. SMITH, D.D.S., P.A.
Entity type:Organization
Organization Name:KYLE M. SMITH, D.D.S., P.A.
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:DENTIST/OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:KYLE
Authorized Official - Middle Name:M
Authorized Official - Last Name:SMITH
Authorized Official - Suffix:
Authorized Official - Credentials:DDS
Authorized Official - Phone:903-456-9888
Mailing Address - Street 1:4818 WELLINGTON ST STE 3
Mailing Address - Street 2:
Mailing Address - City:GREENVILLE
Mailing Address - State:TX
Mailing Address - Zip Code:75402-6010
Mailing Address - Country:US
Mailing Address - Phone:214-592-8042
Mailing Address - Fax:
Practice Address - Street 1:8751 COLLIN MCKINNEY PKWY STE 1502
Practice Address - Street 2:
Practice Address - City:MCKINNEY
Practice Address - State:TX
Practice Address - Zip Code:75070-0230
Practice Address - Country:US
Practice Address - Phone:214-592-8042
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:KYLE M. SMITH, D.D.S., P.A.
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2021-09-07
Last Update Date:2024-05-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1223G0001XDental ProvidersDentistGeneral PracticeGroup - Multi-Specialty
No332BC3200XSuppliersDurable Medical Equipment & Medical SuppliesCustomized EquipmentGroup - Multi-Specialty