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Individual

DR. KYLE D GARDNER

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
Man
Credential
DDS

Contact information

Practice address
650 E 25TH ST, KANSAS CITY, MO 64108-2716
(816) 235-2100
Mailing address
611 LEGENDS BLUFFS CT, EUREKA, MO 63025-3723
(314) 662-6005

Taxonomy

Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
2022021939
MO

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
2022021939
MO
Enumeration date
06/24/2022
Last updated
06/24/2022
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