Individual ProviderKyle David SmithDentistDental ProvidersPractice Address840 N 87th St, Milwaukee, WI 53226-3586(414) 805-5760PECOS EnrollmentBased on the most recent information from CMS, provider Kyle David Smith does not have current enrollment records in PECOS.Part BMedicare Part BNot EnrolledHHAHome Health AgencyNot EnrolledDMEDurable Medical EquipmentNot EnrolledPMDPower Mobility DeviceNot EnrolledCMS last updated its PECOS records 3 days ago.Profile DetailsProvider ID1144529322Provider TypeIndividualFull NameSmith, Kyle DavidTitleDr.CredentialD.D.S.GenderMaleSole ProprietorNoEnumeration Date3/27/2011Last Updated6/11/2015Contact InformationPractice LocationPractice Address840 N 87th St, Milwaukee, WI 53226-3586Phone(414) 805-5760Fax(414) 259-9115Mailing LocationMailing Address840 N 87th St, Milwaukee, WI 53226-3586Phone(414) 805-5760Fax(414) 259-9115Provider TaxonomiesCodeDescriptionLicenseCode1223S0112XPrimaryDescriptionDentistDental ProvidersLicense6771Wisconsin