Individual
JACK MAURICE KIMMERLE
Active
Sole proprietor
Provider details
NPI number
Gender
Man
Credential
DDS
Contact information
Practice address
2445 WINNETKA AVE N, GOLDEN VALLEY, MN 55427-3598
(763) 545-7200
Mailing address
2445 WINNETKA AVE N, GOLDEN VALLEY, MN 55427-3598
Taxonomy
Speciality
Code
Description
License number
State
122300000X
Dentist
Primary
7214
MN
Other
Enumeration date
06/14/2006
Last updated
07/08/2007
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