Organization
MILES 2 SMILES, LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MS. KYLE ISAACS RDHEP (EXPANDED PRACTICE DENTAL HYGIENIST)
(541) 740-4694
Entity
Organization
Contact information
Practice address
24386 BUNKER HILL RD, MONROE, OR 97456-9745
(541) 740-4694
Mailing address
24386 BUNKER HILL RD, MONROE, OR 97456-9745
Taxonomy
Speciality
Code
Description
License number
State
124Q00000X
Dental Hygienist
Primary
H6618
OR
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
1083026884
INDIVIDUAL NPI
OR
Enumeration date
07/20/2015
Last updated
07/20/2015
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