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General NPI Number Information
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NPI Number | 1760571350
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Entity Type | Organization
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Legal Business Name | KYLE D HENSLEY DDS INC
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Dates
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Enumeration Date | 10/12/2006
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Last Update Date | 08/22/2020
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Provider Practice Location Address
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Address Line | 1919 HWY 65 S
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City | CLINTON
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State | AR
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Zip | 72031
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Country | US
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Telephone | 501-745-5393
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Fax | 501-745-3193
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Provider Business Mailing Address
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Address Line | PO BOX 1095
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City | CLINTON
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State | AR
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Zip | 72031
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Country | US
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Telephone | 501-745-5393
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Fax | 501-745-3193
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Authorized Official
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Title or Position | DENTIST
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Name | DR. KYLE D HENSLEY
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Credential | DDS
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Telephone | 501-745-5393
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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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