Provider Demographics
NPI:1588281299
Name:METZGER, DAVID KYLE (DMD)
Entity type:Individual
Prefix:
First Name:DAVID
Middle Name:KYLE
Last Name:METZGER
Suffix:
Gender:M
Credentials:DMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1213 HALL JOHNSON RD STE 100
Mailing Address - Street 2:
Mailing Address - City:COLLEYVILLE
Mailing Address - State:TX
Mailing Address - Zip Code:76034-5806
Mailing Address - Country:US
Mailing Address - Phone:817-428-1800
Mailing Address - Fax:
Practice Address - Street 1:1213 HALL JOHNSON RD STE 100
Practice Address - Street 2:
Practice Address - City:COLLEYVILLE
Practice Address - State:TX
Practice Address - Zip Code:76034-5806
Practice Address - Country:US
Practice Address - Phone:817-879-9400
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2020-06-29
Last Update Date:2020-06-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX362361223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice