Provider Demographics
NPI:1639257959
Name:KIMBROUGH, WILLIAM AUSTIN SR (DDS MS)
Entity Type:Individual
Prefix:MR
First Name:WILLIAM
Middle Name:AUSTIN
Last Name:KIMBROUGH
Suffix:SR
Gender:M
Credentials:DDS MS
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Mailing Address - Street 1:1542 GREEN OAK PLACE
Mailing Address - Street 2:
Mailing Address - City:KINGWOOD
Mailing Address - State:TX
Mailing Address - Zip Code:77339
Mailing Address - Country:US
Mailing Address - Phone:281-358-8551
Mailing Address - Fax:281-358-0230
Practice Address - Street 1:1542 GREEN OAK PLACE
Practice Address - Street 2:
Practice Address - City:KINGWOOD
Practice Address - State:TX
Practice Address - Zip Code:77339
Practice Address - Country:US
Practice Address - Phone:281-358-8551
Practice Address - Fax:281-358-0230
Is Sole Proprietor?:No
Enumeration Date:2006-11-02
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX86901223X0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223X0400XDental ProvidersDentistOrthodontics and Dentofacial Orthopedics