Healthcare Provider Details

I. General information

NPI: 1437011616
Provider Name (Legal Business Name): SMILE BY KYLE LLC, DBA DOVER DENTAL CENTER
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 11/26/2025
Last Update Date: 11/26/2025
Certification Date: 11/26/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

508 LAKEHURST RD STE 3B
TOMS RIVER NJ
08755-8000
US

IV. Provider business mailing address

508 LAKEHURST RD STE 3B
TOMS RIVER NJ
08755-8000
US

V. Phone/Fax

Practice location:
  • Phone: 732-736-9100
  • Fax:
Mailing address:
  • Phone: 732-736-9100
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code122300000X
TaxonomyDentist
License Number
License Number State

VIII. Authorized Official

Name: KENNETH DITMARS
Title or Position: BUSINESS MANAGER
Credential:
Phone: 732-736-9100