Provider Demographics
NPI:1508102153
Name:KIMBALL AND BEECHER PLLC
Entity Type:Organization
Organization Name:KIMBALL AND BEECHER PLLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:BILLING MANAGER
Authorized Official - Prefix:MRS
Authorized Official - First Name:MOLLY
Authorized Official - Middle Name:
Authorized Official - Last Name:SPENCE
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:319-235-6287
Mailing Address - Street 1:3217 CEDAR HEIGHTS DR
Mailing Address - Street 2:
Mailing Address - City:CEDAR FALLS
Mailing Address - State:IA
Mailing Address - Zip Code:50613-6039
Mailing Address - Country:US
Mailing Address - Phone:319-277-6921
Mailing Address - Fax:319-859-2007
Practice Address - Street 1:3217 CEDAR HEIGHTS DR
Practice Address - Street 2:
Practice Address - City:CEDAR FALLS
Practice Address - State:IA
Practice Address - Zip Code:50613-6039
Practice Address - Country:US
Practice Address - Phone:319-277-6921
Practice Address - Fax:319-859-2007
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:KIMBALL AND BEECHER FAMILY DENTISTRY
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2012-12-28
Last Update Date:2012-12-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1223G0001XDental ProvidersDentistGeneral PracticeGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
IA002550832OtherUNITED CONCORDIA