Individual
KYLE HANE
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
DDS
Contact information
Practice address
2730 S MOODY AVE, PORTLAND, OR 97201-5042
(415) 690-8111
Mailing address
3750 S RIVER PKWY APT 656, PORTLAND, OR 97239-4750
(415) 690-8111
Taxonomy
Speciality
Code
Description
License number
State
390200000X
Student in an Organized Health Care Education/Training Program
Primary
—
—
Other
Enumeration date
09/06/2022
Last updated
09/06/2022
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