Individual
KYLE R. JONNA
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Contact information
Practice address
30955 WOODWARD AVE, ROYAL OAK, MI 48073-0800
(248) 397-2010
Mailing address
1987 MEADOW CT, BLOOMFIELD HILLS, MI 48302-1242
(248) 840-2058
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
2901600343
MI
1223G0001X
General Practice Dentistry
2901600343
NY
390200000X
Student in an Organized Health Care Education/Training Program
—
—
Other
Enumeration date
04/27/2018
Last updated
06/04/2021
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