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Individual

MR. JOSEPH BRANDON KIMMEL

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
Man
Credential
LICENSED DENTURIST

Contact information

Practice address
806 YELM AVE E # 7, YELM, WA 98597-9424
(360) 704-9070
Mailing address
7327 5TH AVE SE, LACEY, WA 98503-6706
(360) 704-9070

Taxonomy

Speciality
Code
Description
License number
State
122400000X
Denturist
Primary
DN60737872
WA
122400000X
Denturist

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
DN60737872
DENTURIST LICENSE
WA
Enumeration date
06/27/2017
Last updated
03/14/2024
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