Individual
KYLE MALDONADO
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
DMD
Contact information
Practice address
631 N CHURCH ST, SPARTANBURG, SC 29303-3046
(864) 308-1389
Mailing address
2428 PARK VIEW GREER CIR, GREER, SC 29651
(908) 655-5735
Taxonomy
Speciality
Code
Description
License number
State
122300000X
Dentist
Primary
DGD.10825
SC
1223G0001X
General Practice Dentistry
DGD.10825
SC
Other
Enumeration date
06/21/2024
Last updated
06/21/2024
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