Individual
KIMBERLY NICOLE HAYNES
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
DMD
Contact information
Practice address
435 WARREN ST, ROXBURY, MA 02119-1833
(617) 442-7400
(617) 442-1409
Mailing address
435 WARREN ST, ROXBURY, MA 02119-1833
(617) 442-7400
(617) 442-1409
Taxonomy
Speciality
Code
Description
License number
State
122300000X
Dentist
DL10679
MA
122300000X
Dentist
Primary
DN1855488
MA
Other
Enumeration date
07/08/2009
Last updated
07/22/2010
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