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NPI Code Detail

MEDICARE: KYLE D KOSKI DMD

MEDICARE:   KYLE D KOSKI  DMD
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
11223G0001XGeneral Practice Dentistry30.025491OH

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
130.025491OTHEROHENTITY TYPE 1 (DENTIST)

General Provider Information

NPI Number : 1801380324
Entity Type Code : Individual
Provider Name (Legal Business Name) : KYLE D KOSKI DMD
Provider Business Mailing Address
First Line : 850 BRAINARD RD STE 3
Second Line :
City : HIGHLAND HEIGHTS
State : OH
Zip : 44143-3145
Country : US
Telephone Number : 440-829-4290
Fax Number :
Provider Business Practice Location Address
First Line : 850 BRAINARD RD STE 3
Second Line :
City : HIGHLAND HEIGHTS
State : OH
Zip : 44143-3145
Country : US
Telephone Number : 440-829-4290
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 06/18/2018
Last Update Date : 06/18/2018

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Directions to “ KYLE D KOSKI DMD” Practice Location

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