Individual
DR. KYLE W DIMOND
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
DDS
Contact information
Practice address
1524 LONG ST, SWEET HOME, OR 97386-2313
(541) 367-2931
Mailing address
1290 EVERGREEN LN, SWEET HOME, OR 97386-1301
(541) 818-0545
Taxonomy
Speciality
Code
Description
License number
State
122300000X
Dentist
Primary
D9429
OR
Other
Enumeration date
08/18/2010
Last updated
08/18/2010
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