Sanders, Kyle T

Sanders, Kyle T is an sole proprietor health care provider with primary practice located at 3664 Club Dr Suite 105, Lawrenceville GA 30044-2961. She recently has 2 registered licenses in different health care specialties including Dental Providers / Dentist, Dental Providers / Pediatric Dentistry. Dental Providers / Pediatric Dentistry is her primary health care specialty. Sanders, Kyle T can be contacted via phone (770) 279-7987.

Contact Information

Primary practice address
3664 Club Dr Suite 105 Lawrenceville GA 30044-2961
Fax: (770) 279-8951
Website:

Health care specialties

SpecialtyCodeLicense #State
Dental Providers / Dentist 122300000X 11929 Georgia
Dental Providers / Pediatric Dentistry 1223P0221X 25056 Texas

Profile Details

NPI number 1598735730
LBN Legal business name Sanders, Kyle T
Credentials Doctor of Dental Surgery (DDS)
Entity Individual
Sole proprietor 1 Yes
Enumeration date Jan 23rd, 2006
Last updated Oct 14th, 2009 - about 17 years ago

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

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Identifiers

StateTypeNumberIssuer
All States NPI 1598735730 NPPES
Georgia MEDICAID 000842135F

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