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General NPI Number Information
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NPI Number | 1730318924
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Entity Type | Individual
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Provider Name | KYLE W REYNOLDS D.M.D
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Gender | Male
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Dates
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Enumeration Date | 07/08/2009
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Last Update Date | 07/08/2009
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Provider Practice Location Address
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Address Line | 7901 MALL RD STE 200
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City | FLORENCE
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State | KY
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Zip | 41042-1496
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Country | US
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Telephone | 859-647-7600
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Fax | 859-647-0213
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Provider Business Mailing Address
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Address Line | 7901 MALL RD STE 200
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City | FLORENCE
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State | KY
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Zip | 41042-1496
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Country | US
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Telephone | 859-647-7600
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Fax | 859-647-0213
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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 | 8800
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License Number State | KY
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