Individual
MOZHGAN KIMBLE
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
DDS
Contact information
Practice address
9015 N 3RD ST, PHOENIX, AZ 85020-2444
(480) 882-4545
(602) 870-6348
Mailing address
7500 N DREAMY DRAW DR STE 145, PHOENIX, AZ 85020-4668
(480) 882-4545
(480) 882-5814
Taxonomy
Speciality
Code
Description
License number
State
122300000X
Dentist
4697
AZ
1223G0001X
General Practice Dentistry
Primary
D04697
AZ
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
467789
—
AZ
Enumeration date
10/08/2008
Last updated
01/20/2023
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