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General NPI Number Information
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NPI Number | 1598690810
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Entity Type | Organization
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Legal Business Name | KIMBALL & BEECHER BERKSHIRE
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Dates
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Enumeration Date | 06/17/2026
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Last Update Date | 06/17/2026
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Provider Practice Location Address
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Address Line | 2375 BERKSHIRE PKWY
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City | CLIVE
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State | IA
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Zip | 50325-4677
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Country | US
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Telephone | 515-987-7670
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Fax |
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Provider Business Mailing Address
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Address Line | 4015 HURST DR
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City | WATERLOO
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State | IA
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Zip | 50701-9035
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Country | US
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Telephone | 319-235-6287
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Fax |
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Authorized Official
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Title or Position | CONTROLLER
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Name | SANDY MARIE CROCK
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Credential |
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Telephone | 319-277-6921
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 1223G0001X
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Taxonomy Name | General Practice Dentistry
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License Number |
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License Number State |
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