Individual
DR. KYLE STEPHEN NOVOTNY
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
DDS
Contact information
Practice address
12265 CENTRAL AVE NE, BLAINE, MN 55434-3961
(763) 757-1323
Mailing address
12265 CENTRAL AVE NE, BLAINE, MN 55434-3961
(763) 757-1323
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
D14428
MN
Other
Enumeration date
07/14/2020
Last updated
07/14/2020
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