Individual
KELLY LYTLE
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
DDS
Contact information
Practice address
3312 JACKSON BLVD, RAPID CITY, SD 57702-3346
(605) 342-0989
Mailing address
3312 JACKSON BLVD, RAPID CITY, SD 57702-3346
(605) 342-0989
Taxonomy
Speciality
Code
Description
License number
State
122300000X
Dentist
Primary
M723
SD
Other
Enumeration date
05/01/2008
Last updated
05/01/2008
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