Provider Demographics
NPI:1316131675
Name:KYLE S EBERHARDT DDS & BRONLYNN A EBERHARDT DDS LLC
Entity type:Organization
Organization Name:KYLE S EBERHARDT DDS & BRONLYNN A EBERHARDT DDS LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:KYLE
Authorized Official - Middle Name:
Authorized Official - Last Name:EBERHARDT
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:330-836-5585
Mailing Address - Street 1:1655 W MARKET ST
Mailing Address - Street 2:
Mailing Address - City:AKRON
Mailing Address - State:OH
Mailing Address - Zip Code:44313-7004
Mailing Address - Country:US
Mailing Address - Phone:330-836-5585
Mailing Address - Fax:
Practice Address - Street 1:1655 W MARKET ST
Practice Address - Street 2:
Practice Address - City:AKRON
Practice Address - State:OH
Practice Address - Zip Code:44313-7004
Practice Address - Country:US
Practice Address - Phone:330-836-5585
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-08-30
Last Update Date:2007-08-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes122300000XDental ProvidersDentistGroup - Single Specialty