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General NPI Number Information
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NPI Number | 1932827896
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Entity Type | Organization
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Legal Business Name | KYLE MCGILL DDS PC
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Dates
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Enumeration Date | 08/17/2022
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Last Update Date | 08/17/2022
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Provider Practice Location Address
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Address Line | 10 N STATE ST
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City | NILES
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State | MI
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Zip | 49120-2295
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Country | US
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Telephone | 269-684-6003
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Fax |
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Provider Business Mailing Address
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Address Line | 10 N STATE ST
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City | NILES
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State | MI
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Zip | 49120-2295
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Country | US
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Telephone | 269-684-6003
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Fax |
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Authorized Official
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Title or Position | PRESIDENT
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Name | DR. KYLE PATRICK MCGILL
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Credential | DDS
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Telephone | 269-684-6003
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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 |
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License Number State |
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