Black, Matthew Kimball
Black, Matthew Kimball is an individual health care provider with primary practice located at 512 N Young St , Kennewick WA 99336-7839. He recently has 2 registered licenses in different health care specialties including Student, Health Care / Student in an Organized Health Care Education/Training Program, Dental Providers / Oral and Maxillofacial Surgery. Dental Providers / Oral and Maxillofacial Surgery is his primary health care specialty. Black, Matthew Kimball can be contacted via phone (509) 783-7600.Contact Information
Primary practice address
512 N Young St
Kennewick WA 99336-7839
Phone: (509) 783-7600
Fax: (509) 783-0774
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Student, Health Care / Student in an Organized Health Care Education/Training Program | 390200000X | ||
| Dental Providers / Oral and Maxillofacial Surgery | 1223S0112X | 61025296 | Washington |
Profile Details
| NPI number | 1891173282 |
|---|---|
| LBN Legal business name | Black, Matthew Kimball |
| Credentials | Doctor of Dental Surgery (DDS) |
| Entity | Individual |
| Sole proprietor 1 | No |
| Enumeration date | May 18th, 2015 |
| Last updated | Aug 28th, 2020 - about 6 years ago |
1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.
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