Provider Demographics
NPI:1972346443
Name:KYLE, ERICA ELIZABETH (RDH)
Entity type:Individual
Prefix:
First Name:ERICA
Middle Name:ELIZABETH
Last Name:KYLE
Suffix:
Gender:F
Credentials:RDH
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:HC 4 BOX 708
Mailing Address - Street 2:
Mailing Address - City:CALIFORNIA HOT SPRINGS
Mailing Address - State:CA
Mailing Address - Zip Code:93207-9704
Mailing Address - Country:US
Mailing Address - Phone:559-361-8043
Mailing Address - Fax:
Practice Address - Street 1:1430 TRUXTUN AVE STE 400
Practice Address - Street 2:
Practice Address - City:BAKERSFIELD
Practice Address - State:CA
Practice Address - Zip Code:93301-5220
Practice Address - Country:US
Practice Address - Phone:661-635-3050
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2024-06-13
Last Update Date:2024-06-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA20900124Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes124Q00000XDental ProvidersDental Hygienist