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Organization
KYLE NOVOTNY DDS PLLC
Active
Organization
KYLE NOVOTNY DDS PLLC
Active
Other names
Legacy Dental Care
Organization subpart
No
Provider details
NPI number
Authorized official
DR. KYLE STEPHEN NOVOTNY DDS (OWNER)
(763) 757-1323
Entity
Organization
Contact information
Practice address
12265 CENTRAL AVE NE, BLAINE, MN 55434-3961
(763) 757-1323
(763) 757-1037
Mailing address
12265 CENTRAL AVE NE, BLAINE, MN 55434-3961
(763) 757-1323
(763) 757-1037
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
—
—
Other
Enumeration date
12/29/2022
Last updated
12/29/2022
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