Individual
KYLE O'CONNOR
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
DDS
Contact information
Practice address
2401 BORST AVE, CENTRALIA, WA 98531-1411
(360) 736-1151
Mailing address
132A PLEASANT HILL RD, CHEHALIS, WA 98532-9112
(360) 480-3759
Taxonomy
Speciality
Code
Description
License number
State
122300000X
Dentist
Primary
DE61085949
WA
Other
Enumeration date
09/22/2020
Last updated
09/22/2020
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