Individual
KYLE SMITH
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Contact information
Practice address
6020 35TH AVE SW, SEATTLE, WA 98126-3002
(206) 461-6966
(206) 461-6968
Mailing address
6020 35TH AVE SW, SEATTLE, WA 98126-3002
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
DE60777210
WA
390200000X
Student in an Organized Health Care Education/Training Program
—
—
Other
Enumeration date
05/01/2016
Last updated
11/02/2017
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