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General NPI Number Information
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NPI Number | 1528575594
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Entity Type | Organization
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Legal Business Name | SCHNEIDER, D.D.S.& KYE, D.D.S., PA
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Dates
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Enumeration Date | 12/29/2017
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Last Update Date | 12/29/2017
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Provider Practice Location Address
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Address Line | 9336 BLAKENEY CENTER DRIVE SUITE 100-A
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City | CHARLOTTE
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State | NC
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Zip | 28277-2827
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Country | US
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Telephone | 704-759-8210
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Fax | 704-759-8210
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Provider Business Mailing Address
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Address Line | 9336 BLAKENEY CENTRE DR STE 100A
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City | CHARLOTTE
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State | NC
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Zip | 28277-6667
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Country | US
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Telephone | 704-759-8210
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Fax |
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Authorized Official
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Title or Position | OWNER/DENTIST
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Name | DR. KEITH KYE
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Credential | DDS
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Telephone | 704-759-8210
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261QD0000X
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Taxonomy Name | Dental Clinic/Center
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License Number | 6149
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License Number State | NC
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