Provider Demographics
NPI:1619715554
Name:KIDD, SYDNEY
Entity type:Individual
Prefix:
First Name:SYDNEY
Middle Name:
Last Name:KIDD
Suffix:
Gender:M
Credentials:
Other - Prefix:DR
Other - First Name:SYDNEY
Other - Middle Name:
Other - Last Name:KIDD
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:DMD
Mailing Address - Street 1:11720 BALCH SPRINGS CT
Mailing Address - Street 2:
Mailing Address - City:FRISCO
Mailing Address - State:TX
Mailing Address - Zip Code:75035-8837
Mailing Address - Country:US
Mailing Address - Phone:214-395-9617
Mailing Address - Fax:
Practice Address - Street 1:11720 BALCH SPRINGS CT
Practice Address - Street 2:
Practice Address - City:FRISCO
Practice Address - State:TX
Practice Address - Zip Code:75035-8837
Practice Address - Country:US
Practice Address - Phone:214-395-9617
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2024-07-16
Last Update Date:2024-07-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX40353122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist