Organization
HEAVENLY DENTAL ASSOCIATES
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. HEAVENLY E KIMES DDS (OWNER)
(678) 625-7505
Entity
Organization
Contact information
Practice address
3162 ELM ST NE, COVINGTON, GA 30014-2461
(678) 625-7505
(678) 625-0207
Mailing address
3162 ELM ST NE, COVINGTON, GA 30014-2461
(678) 625-7505
(678) 625-0207
Taxonomy
Speciality
Code
Description
License number
State
122300000X
Dentist
Primary
DN012304
GA
Other
Enumeration date
06/24/2008
Last updated
06/24/2008
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