Individual
KIMBERLY GREENWELL
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
DMD
Contact information
Practice address
709 MOBJACK PL, NEWPORT NEWS, VA 23606-1929
(757) 873-3001
Mailing address
709 MOBJACK PL, NEWPORT NEWS, VA 23606-1929
(757) 873-3001
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
0401411289
VA
1223G0001X
General Practice Dentistry
7938
KY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
60003209
—
KY
01
—
9178015
DORAL DENTAL
KY
Enumeration date
06/28/2005
Last updated
07/08/2007
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