Individual
DR. TODD SHUJI KIMURA
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
DDS
Contact information
Practice address
4TH & INTERLOOP ROAD, BLDG 171, US ARMY DENTAL ACTIVITY, ATTN: FRAN GERNERT CREDENTIALS, FORT IRWIN, CA 92311
(719) 526-5537
(719) 524-2843
Mailing address
1631 WETZEL AVENUE, BLDG 815, US ARMY DENTAL ACTIVITY, ATTN: FRAN GERNERT CREDENTIALS, FORT CARSON, CO 80913
(719) 526-5537
(719) 524-2843
Taxonomy
Speciality
Code
Description
License number
State
1223X0400X
Orthodontics and Dentofacial Orthopedics Dentistry
43803
CA
1223X0400X
Orthodontics and Dentofacial Orthopedics Dentistry
Primary
DT-2429
HI
Other
Enumeration date
12/07/2005
Last updated
08/14/2012
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