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General NPI Number Information
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NPI Number | 1669998449
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Entity Type | Individual
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Provider Name | KYLE BRADLEY HING DDS
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Gender | Male
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Dates
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Enumeration Date | 08/14/2017
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Last Update Date | 08/14/2017
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Provider Practice Location Address
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Address Line | 3171 RIVERSIDE BLVD
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City | SACRAMENTO
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State | CA
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Zip | 95818-3754
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Country | US
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Telephone | 916-320-4567
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Fax |
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Provider Business Mailing Address
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Address Line | 779 SKYLAKE WAY
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City | SACRAMENTO
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State | CA
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Zip | 95831-2601
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Country | US
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Telephone | 916-320-4567
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 1223G0001X
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Taxonomy Name | General Practice Dentistry
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License Number | 101877
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License Number State | CA
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