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General NPI Number Information
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NPI Number | 1063959864
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Entity Type | Organization
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Legal Business Name | KYGER DENTAL ASSOCIATES INC
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Dates
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Enumeration Date | 01/31/2017
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Last Update Date | 01/31/2017
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Provider Practice Location Address
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Address Line | 878 JACKSON PIKE
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City | GALLIPOLIS
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State | OH
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Zip | 45631-1391
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Country | US
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Telephone | 740-446-7806
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Fax | 740-446-4840
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Provider Business Mailing Address
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Address Line | 878 JACKSON PIKE
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City | GALLIPOLIS
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State | OH
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Zip | 45631-1391
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Country | US
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Telephone | 740-446-7806
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Fax | 740-446-4840
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Authorized Official
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Title or Position | OWNER
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Name | DR. TIMOTHY VIRGIL KYGER
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Credential | D.D.S.
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Telephone | 740-446-7806
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 122300000X
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Taxonomy Name | Dentist
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License Number | 30015773
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License Number State | OH
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