MEDICARE: DR. KYLIE NICOLE SAATHOFF DDS

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	1223G0001X	General Practice Dentistry	23364	TX

General Provider Information

NPI Number	:	1629260047
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. KYLIE NICOLE SAATHOFF DDS

Provider Business Mailing Address
First Line	:	12410 HORSE CRES
Second Line	:
City	:	SAN ANTONIO
State	:	TX
Zip	:	78254-6087
Country	:	US
Telephone Number	:	210-326-6911
Fax Number	:

Provider Business Practice Location Address
First Line	:	834 SW MILITARY DR
Second Line	:
City	:	SAN ANTONIO
State	:	TX
Zip	:	78221-1527
Country	:	US
Telephone Number	:	210-927-9998
Fax Number	:	210-927-9978

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	08/10/2007
Last Update Date	:	07/11/2011

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