Individual
KYLE A HARRISON
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
DDS
Contact information
Practice address
506 CORDA BLVD, CRAWFORDSVILLE, IN 47933-4935
(765) 362-3333
Mailing address
1425 PENN CIRCLE DR UNIT 207, CARMEL, IN 46032-6116
(765) 366-5686
Taxonomy
Speciality
Code
Description
License number
State
122300000X
Dentist
Primary
12013418A
IN
1223G0001X
General Practice Dentistry
12013418A
IN
Other
Enumeration date
03/30/2019
Last updated
10/08/2022
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