Individual
MISS KIMBERLY KAY WALLER-BROWN
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
D.D.S.
Contact information
Practice address
1609 MARYLAND AVE, BLUEFIELD, WV 24701-3803
(304) 327-5506
(304) 324-8703
Mailing address
1609 MARYLAND AVE, BLUEFIELD, WV 24701-3803
(304) 327-5506
(304) 327-5506
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
3587
WV
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
3810000311
—
WV
Enumeration date
11/09/2006
Last updated
05/15/2015
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