Provider Demographics
NPI:1982737730
Name:MORGAN, KYLE S (DDS)
Entity type:Individual
Prefix:
First Name:KYLE
Middle Name:S
Last Name:MORGAN
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 1:47 E CRESTWOOD RD
Mailing Address - Street 2:SUITE 5
Mailing Address - City:KAYSVILLE
Mailing Address - State:UT
Mailing Address - Zip Code:84037
Mailing Address - Country:US
Mailing Address - Phone:801-546-2439
Mailing Address - Fax:801-546-0759
Practice Address - Street 1:47 E CRESTWOOD RD
Practice Address - Street 2:SUITE 5
Practice Address - City:KAYSVILLE
Practice Address - State:UT
Practice Address - Zip Code:84037
Practice Address - Country:US
Practice Address - Phone:801-546-2439
Practice Address - Fax:801-546-0759
Is Sole Proprietor?:No
Enumeration Date:2007-03-13
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
UT1223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice