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Individual

DR. KYLE NATHANIEL BERRONG

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
Man
Credential
DDS

Contact information

Practice address
8901 WISCONSIN AVE OMFS CLINIC BLDG 9, 2ND DECK RM 2505, BETHESDA, MD 20889-6122
(301) 295-4340
Mailing address
1413 LINCOLNSHIRE DR, MARYVILLE, TN 37803-7702
(865) 773-9285

Taxonomy

Speciality
Code
Description
License number
State
122300000X
Dentist
10250
TN
171000000X
Military Health Care Provider
Primary
10250
TN

Other

Enumeration date
07/20/2016
Last updated
08/22/2023
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