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Individual
STORM NICOLE KIMBROW
Active
Individual
STORM NICOLE KIMBROW
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
DDS
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
11516
TN
1223G0001X
General Practice Dentistry
Primary
38166
TX
390200000X
Student in an Organized Health Care Education/Training Program
—
—
Other
Enumeration date
07/07/2020
Last updated
03/21/2022
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