Provider Demographics
NPI:1912437781
Name:SHARP, KYLE C (DDS)
Entity type:Individual
Prefix:DR
First Name:KYLE
Middle Name:C
Last Name:SHARP
Suffix:
Gender:M
Credentials:DDS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2600 MARKET TRCE STE B
Mailing Address - Street 2:
Mailing Address - City:FORT SMITH
Mailing Address - State:AR
Mailing Address - Zip Code:72908-8681
Mailing Address - Country:US
Mailing Address - Phone:479-648-9988
Mailing Address - Fax:
Practice Address - Street 1:2600 MARKET TRCE STE B
Practice Address - Street 2:
Practice Address - City:FORT SMITH
Practice Address - State:AR
Practice Address - Zip Code:72908-8681
Practice Address - Country:US
Practice Address - Phone:479-648-9988
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2017-06-14
Last Update Date:2024-09-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AR41701223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice