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General NPI Number Information
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NPI Number | 1235159633
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Entity Type | Organization
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Legal Business Name | MARK A. KYLE, D.D.S., INC.
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Dates
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Enumeration Date | 07/20/2006
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Last Update Date | 08/22/2020
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Provider Practice Location Address
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Address Line | 6801 MAYFIELD RD SUITE 246
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City | MAYFIELD HEIGHTS
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State | OH
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Zip | 44124-2270
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Country | US
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Telephone | 440-449-0300
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Fax |
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Provider Business Mailing Address
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Address Line | 6801 MAYFIELD RD SUITE 246
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City | MAYFIELD HEIGHTS
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State | OH
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Zip | 44124-2270
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Country | US
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Telephone | 440-449-0300
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Fax |
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Authorized Official
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Title or Position | OWNER
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Name | DR. MARK ALLEN KYLE
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Credential | D.D.S.
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Telephone | 440-449-0300
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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 | 17104
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License Number State | OH
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