Individual
DR. KYLE MICHAEL MALDONADO
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
DDS
Contact information
Practice address
808 C M FAGAN DR, HAMMOND, LA 70403
(985) 542-8719
Mailing address
808 C M FAGAN DR, HAMMOND, LA 70403-6049
(985) 542-8719
Taxonomy
Speciality
Code
Description
License number
State
1223X0400X
Orthodontics and Dentofacial Orthopedics Dentistry
Primary
6781
LA
Other
Enumeration date
06/12/2017
Last updated
09/24/2019
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