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Individual

DR. KYLE JEFFREY BEULKE

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
D.D.S.

Contact information

Practice address
739 PRESIDENT PL, SMYRNA, TN 37167-6844
(402) 968-2007
Mailing address
2946 PRIMROSE CIR, NASHVILLE, TN 37212-6016
(402) 968-2007

Taxonomy

Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
RES.3338
OH
1223P0221X
Pediatric Dentistry
Primary
DS0000010263
TN
390200000X
Student in an Organized Health Care Education/Training Program
30413
IA

Other

Enumeration date
07/01/2013
Last updated
08/17/2016
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