Individual
KYLE IVEY
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
DMD
Contact information
Practice address
6958 NEBRASKA AVE, FORT LEONARD WOOD, MO 65473-1618
(573) 596-0364
Mailing address
6958 NEBRASKA AVE BLDG 1608, FORT LEONARD WOOD, MO 65473-1618
(573) 596-0364
Taxonomy
Speciality
Code
Description
License number
State
122300000X
Dentist
04245
NH
1223G0001X
General Practice Dentistry
Primary
04245
NH
Other
Enumeration date
08/04/2016
Last updated
10/14/2025
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