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General NPI Number Information
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NPI Number | 1427577972
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Entity Type | Organization
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Legal Business Name | JEFFREY M KYES DMD
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Dates
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Enumeration Date | 09/15/2017
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Last Update Date | 09/15/2017
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Provider Practice Location Address
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Address Line | 168 W BROADWAY
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City | LINCOLN
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State | ME
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Zip | 04457-4003
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Country | US
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Telephone | 207-794-6577
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Fax | 207-794-8383
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Provider Business Mailing Address
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Address Line | PO BOX 26
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City | LINCOLN
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State | ME
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Zip | 04457-0026
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Country | US
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Telephone | 207-794-6577
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Fax | 207-794-8383
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Authorized Official
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Title or Position | OWNER
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Name | DR. JEFFREY M KYES
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Credential | DMD
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Telephone | 207-794-6577
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 332B00000X
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Taxonomy Name | Durable Medical Equipment & Medical Supplies
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License Number | 2931
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License Number State | ME
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