Kyle Prohovich, DR.

NPI #1174015887 in Windham, New Hampshire

Provider Information

NPI Number: 1174015887
Entity Type: Individual
Name: Kyle Prohovich, DR.
Gender: Not Specified
Sole Proprietor: Yes
Primary Specialty: Student in an Organized Health Care Education/Training Program
Credential: DR.
Enumeration Date: May 30, 2018
Last Updated: Oct 30, 2018

Practice Location

Address: 9 FAITH RD
City: Windham
State: New Hampshire
ZIP Code: 03087-1554
Phone: (617) 335-2650

Specialties & Taxonomy Codes

Specialty	Taxonomy Code	Primary
Dentist	122300000X
Student in an Organized Health Care Education/Training Program	390200000X	Primary

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