Provider Demographics
NPI:1861632044
Name:DANIEL, KYLE (DDS)
Entity type:Individual
Prefix:DR
First Name:KYLE
Middle Name:
Last Name:DANIEL
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 1:2800 VALMONT RD
Mailing Address - Street 2:
Mailing Address - City:BOULDER
Mailing Address - State:CO
Mailing Address - Zip Code:80301-1310
Mailing Address - Country:US
Mailing Address - Phone:303-444-3232
Mailing Address - Fax:303-444-3242
Practice Address - Street 1:2800 VALMONT RD
Practice Address - Street 2:
Practice Address - City:BOULDER
Practice Address - State:CO
Practice Address - Zip Code:80301-1310
Practice Address - Country:US
Practice Address - Phone:303-444-3232
Practice Address - Fax:303-444-3242
Is Sole Proprietor?:No
Enumeration Date:2009-02-27
Last Update Date:2022-07-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IN12011265A1223G0001X
CO98341223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice