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General NPI Number Information
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NPI Number | 1386763050
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Entity Type | Individual
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Provider Name | KIMBERLY WILLIAMS CHUBB DMD
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Gender | Female
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Dates
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Enumeration Date | 03/27/2007
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Last Update Date | 07/21/2023
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Provider Practice Location Address
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Address Line | 3229 HIGHWAY 34 E SUITE 101
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City | NEWNAN
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State | GA
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Zip | 30265-2195
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Country | US
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Telephone | 770-304-0034
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Fax | 770-304-3439
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Provider Business Mailing Address
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Address Line | PO BOX 72029
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City | NEWNAN
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State | GA
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Zip | 30271-2029
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Country | US
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Telephone | 770-304-0034
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Fax | 770-304-3439
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 122300000X
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Taxonomy Name | Dentist
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License Number | DN011845
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License Number State | GA
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