Individual
DR. ERIC LEE KIMBALL
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
D.D.S.
Contact information
Practice address
315 E SAN MARNAN DR, WATERLOO, IA 50702-5837
(319) 235-6287
(319) 235-6740
Mailing address
301 SHERIDAN RD, WATERLOO, IA 50701-4023
(319) 232-8386
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
7999
IA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
41948
WELLMARK BCBS PROVIDER #
—
01
—
640-03389
BCBS OF ALABAMA
AL
01
—
742541
UNITED CONCORDIA
—
01
—
7999IA 002
DELTA DENTAL OF IOWA
IA
Enumeration date
08/11/2006
Last updated
07/08/2007
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