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General NPI Number Information
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NPI Number | 1700026713
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Entity Type | Organization
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Legal Business Name | JOAN H. KIMBALL, DMD
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Dates
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Enumeration Date | 03/03/2009
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Last Update Date | 03/03/2009
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Provider Practice Location Address
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Address Line | 15 WENTWORTH AVE
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City | PLAISTOW
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State | NH
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Zip | 03865-3136
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Country | US
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Telephone | 603-382-5138
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Fax | 603-382-6071
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Provider Business Mailing Address
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Address Line | 15 WENTWORTH AVE
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City | PLAISTOW
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State | NH
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Zip | 03865-3136
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Country | US
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Telephone | 603-382-5138
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Fax | 603-382-6071
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Authorized Official
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Title or Position | DENTIST
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Name | DR. JOAN HARWOOD KIMBALL
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Credential | DMD
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Telephone | 603-382-5138
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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 | 2238
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License Number State | NH
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Taxonomy #2
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Taxonomy Code | 1223G0001X
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Taxonomy Name | General Practice Dentistry
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License Number | 2238
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License Number State | NH
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