MEDICARE: DR. KIMBERLY ANN ARNOLD D.M.D.

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	1223G0001X	General Practice Dentistry	6799	KY

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	4055956	OTHER		BCBS ID
2	537849	OTHER		UNITED CONCORDIA ID

General Provider Information

NPI Number	:	1487798450
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. KIMBERLY ANN ARNOLD D.M.D.

Provider Business Mailing Address
First Line	:	PO BOX 356
Second Line	:
City	:	CATLETTSBURG
State	:	KY
Zip	:	41129-0356
Country	:	US
Telephone Number	:	606-739-5151
Fax Number	:	606-739-4301

Provider Business Practice Location Address
First Line	:	3161 OAKLAND AVE
Second Line	:
City	:	CATLETTSBURG
State	:	KY
Zip	:	41129-1155
Country	:	US
Telephone Number	:	606-739-5151
Fax Number	:	606-739-4301

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	02/16/2007
Last Update Date	:	02/25/2010

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