Individual
DR. KYLE GLASS
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
DMD
Contact information
Practice address
593 EDDY ST, PROVIDENCE, RI 02903-4923
(401) 444-7195
(401) 444-0984
Mailing address
593 EDDY ST, PROVIDENCE, RI 02903-4923
(401) 444-7195
(401) 444-0984
Taxonomy
Speciality
Code
Description
License number
State
122300000X
Dentist
Primary
LD00148
RI
Other
Enumeration date
07/02/2018
Last updated
07/02/2018
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