Organization
KIMBERLY A EBNER DDS INC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. KIMBERLY ANN EBNER DDS (OWNER)
(626) 796-9246
Entity
Organization
Contact information
Practice address
1060 E GREEN STREET, SUITE 105, PASADENA, CA 91106
(626) 796-9246
(626) 564-8395
Mailing address
1060 E GREEN STREET, SUITE 105, PASADENA, CA 91106
(626) 796-9246
(626) 564-8395
Taxonomy
Speciality
Code
Description
License number
State
1223S0112X
Oral and Maxillofacial Surgery (Dentist)
Primary
D37328
CA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
877058
UNITED CONCORDIA
—
Enumeration date
12/16/2005
Last updated
10/25/2007
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