Individual
DR. KYLE PATRICK GEARHART
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
DDS
Contact information
Practice address
15785 95TH AVE N, MAPLE GROVE, MN 55369-4404
(763) 420-5484
(763) 420-5875
Mailing address
3747 INDEPENDENCE AVE N, NEW HOPE, MN 55427-1628
(612) 202-6278
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
D12103
MN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
31658000
—
MN
Enumeration date
12/07/2006
Last updated
07/08/2007
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