Provider Demographics
NPI:1407950025
Name:HAL H. KIMOWITZ D.M.D. , P.A.
Entity Type:Organization
Organization Name:HAL H. KIMOWITZ D.M.D. , P.A.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:DENTIST/PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:HAL
Authorized Official - Middle Name:H
Authorized Official - Last Name:KIMOWITZ
Authorized Official - Suffix:
Authorized Official - Credentials:DMD
Authorized Official - Phone:973-627-3363
Mailing Address - Street 1:75 BLOOMFIELD AVE
Mailing Address - Street 2:
Mailing Address - City:DENVILLE
Mailing Address - State:NJ
Mailing Address - Zip Code:07834-2735
Mailing Address - Country:US
Mailing Address - Phone:973-627-3363
Mailing Address - Fax:
Practice Address - Street 1:75 BLOOMFIELD AVE
Practice Address - Street 2:
Practice Address - City:DENVILLE
Practice Address - State:NJ
Practice Address - Zip Code:07834-2735
Practice Address - Country:US
Practice Address - Phone:973-627-3363
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-09-12
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ0104641223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1223G0001XDental ProvidersDentistGeneral PracticeGroup - Single Specialty