Individual
KIMBERLY R SELF
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
D.D.S.
Contact information
Practice address
1296 AGVIK STREET, BARROW, AK 99723-0029
(907) 852-9221
(907) 852-9297
Mailing address
1296 AGVIK STREET, PO BOX 29, BARROW, AK 99723-0029
(907) 852-9221
(907) 852-9297
Taxonomy
Speciality
Code
Description
License number
State
122300000X
Dentist
Primary
1395
AK
122300000X
Dentist
24630
TX
Other
Enumeration date
11/19/2009
Last updated
07/18/2012
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