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General NPI Number Information
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NPI Number | 1689536864
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Entity Type | Organization
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Legal Business Name | SMILE BY KYLE LLC, DBA BRIELLE HILLS DENTAL
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Dates
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Enumeration Date | 11/26/2025
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Last Update Date | 11/26/2025
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Provider Practice Location Address
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Address Line | 2640 ROUTE 70 STE 2D
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City | MANASQUAN
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State | NJ
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Zip | 08736-2610
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Country | US
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Telephone | 732-223-2334
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Fax |
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Provider Business Mailing Address
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Address Line | 2640 ROUTE 70 STE 2D
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City | MANASQUAN
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State | NJ
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Zip | 08736-2610
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Country | US
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Telephone | 732-223-2334
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Fax |
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Authorized Official
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Title or Position | BUSINESS MANAGER
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Name | KENNETH DITMARS
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Credential |
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Telephone | 732-736-9100
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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 |
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License Number State |
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