MEDICARE: KYLE & OSTER DENTAL PARTNERSHIP

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	261QD0000X	Dental Clinic/Center

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	1235225145	OTHER	CA	NPI

General Provider Information

NPI Number	:	1023840949
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	KYLE & OSTER DENTAL PARTNERSHIP

Provider Business Mailing Address
First Line	:	2539 FOREST AVE
Second Line	:
City	:	CHICO
State	:	CA
Zip	:	95928-7686
Country	:	US
Telephone Number	:	530-342-6064
Fax Number	:	530-342-6064

Provider Business Practice Location Address
First Line	:	2539 FOREST AVE
Second Line	:
City	:	CHICO
State	:	CA
Zip	:	95928-7686
Country	:	US
Telephone Number	:	530-342-6064
Fax Number	:	530-342-0971

Authorized Official
Title or Position	:	OWNER/PARTNER
Name	:	DAVID C KYLE
Credential	:	DDS
Telephone Number	:	530-342-6064

Provider Enumeration Date	:	08/19/2024
Last Update Date	:	08/19/2024

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