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General NPI Number Information
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NPI Number | 1952069627
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Entity Type | Organization
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Legal Business Name | KYLE J STUART DMD,PA
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Dates
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Enumeration Date | 11/30/2021
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Last Update Date | 11/30/2021
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Provider Practice Location Address
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Address Line | 216 N MAIN ST STE B
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City | TRENTON
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State | FL
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Zip | 32693-3427
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Country | US
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Telephone | 352-463-2665
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Fax | 352-463-6848
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Provider Business Mailing Address
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Address Line | 216 N MAIN ST STE B
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City | TRENTON
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State | FL
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Zip | 32693-3427
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Country | US
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Telephone | 352-463-2665
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Fax | 352-463-6848
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Authorized Official
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Title or Position | OFFICE MANAGER
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Name | LORI WILLIAMS
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Credential |
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Telephone | 352-463-2665
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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 |
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License Number State |
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