Provider Demographics
NPI:1962028753
Name:SELL, KIMBERLEE (DMD)
Entity Type:Individual
Prefix:DR
First Name:KIMBERLEE
Middle Name:
Last Name:SELL
Suffix:
Gender:F
Credentials:DMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:103 SCEPTRE DR
Mailing Address - Street 2:
Mailing Address - City:ROCKWALL
Mailing Address - State:TX
Mailing Address - Zip Code:75032-5720
Mailing Address - Country:US
Mailing Address - Phone:928-651-2961
Mailing Address - Fax:
Practice Address - Street 1:5800 N I 35 STE 205
Practice Address - Street 2:
Practice Address - City:DENTON
Practice Address - State:TX
Practice Address - Zip Code:76207-1438
Practice Address - Country:US
Practice Address - Phone:940-312-5633
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2020-06-17
Last Update Date:2020-06-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX36164122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist