Kimball, Eric Lee

Kimball, Eric Lee is an individual health care provider with primary practice located at 315 E San Marnan Dr , Waterloo IA 50702-5837. He recently has only one registered license in Dental Providers / General Practice, which is considered as his primary health care specialty. Kimball, Eric Lee can be contacted via phone (319) 235-6287.

Contact Information

Primary practice address
315 E San Marnan Dr Waterloo IA 50702-5837
Phone: (319) 235-6287
Fax: (319) 235-6740
Website:
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Health care specialties

SpecialtyCodeLicense #State
Dental Providers / General Practice 1223G0001X 7999 Iowa

Profile Details

NPI number 1639180920
LBN Legal business name Kimball, Eric Lee
Credentials Doctor of Dental Surgery (DDS)
Entity Individual
Sole proprietor 1 No
Enumeration date Aug 11th, 2006
Last updated Jul 8th, 2007 - about 19 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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Identifiers

StateTypeNumberIssuer
All States NPI 1639180920 NPPES
Other 41948 WELLMARK BCBS PROVIDER #
Other 640-03389 WELLMARK BCBS PROVIDER #
Other 7999IA 002 WELLMARK BCBS PROVIDER #
Other 742541 WELLMARK BCBS PROVIDER #

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