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General NPI Number Information
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NPI Number | 1609948041
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Entity Type | Organization
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Legal Business Name | JEFFREY A. KIMELMAN, DMD, PC
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Dates
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Enumeration Date | 11/14/2006
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Last Update Date | 12/08/2009
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Provider Practice Location Address
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Address Line | 123 EGG HARBOR ROAD SUITE 500
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City | SEWELL
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State | NJ
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Zip | 08080
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Country | US
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Telephone | 856-227-8888
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Fax | 856-227-8001
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Provider Business Mailing Address
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Address Line | 123 EGG HARBOR ROAD SUITE 500
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City | SEWELL
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State | NJ
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Zip | 08080
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Country | US
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Telephone | 856-227-8888
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Fax | 856-227-8001
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Authorized Official
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Title or Position | PRESIDENT
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Name | DR. JEFFREY A KIMELMAN
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Credential | DMD
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Telephone | 856-227-8888
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 1223S0112X
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Taxonomy Name | Oral and Maxillofacial Surgery (Dentist)
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License Number | 16154
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License Number State | NJ
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