| Kyle Novotny Dds Pllc | |
|
12265 Central Ave Ne Blaine MN 55434-3961 | |
| (763) 757-1323 | |
| (763) 757-1037 |
| Full Name | Kyle Novotny Dds Pllc |
|---|---|
| Speciality | Dentist - General Practice |
| Location | 12265 Central Ave Ne, Blaine, Minnesota |
| Authorized Official Name and Position | Kyle Stephen Novotny (OWNER) |
| Authorized Official Contact | 7637571323 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Kyle Novotny Dds Pllc 12265 Central Ave Ne Blaine MN 55434-3961 Ph: (763) 757-1323 | Kyle Novotny Dds Pllc 12265 Central Ave Ne Blaine MN 55434-3961 Ph: (763) 757-1323 |
| NPI Number | 1255044723 |
|---|---|
| Provider Enumeration Date | 12/29/2022 |
| Last Update Date | 12/29/2022 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1255044723 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 1223G0001X | Dentist - General Practice | (* (Not Available)) | Primary |
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