Provider Demographics
NPI:1962656397
Name:SHEFFIELD, KIMBAL COVENTRY (DDS)
Entity Type:Individual
Prefix:
First Name:KIMBAL
Middle Name:COVENTRY
Last Name:SHEFFIELD
Suffix:
Gender:M
Credentials:DDS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1040 N. MAIN STREET
Mailing Address - Street 2:KIMBAL SHEFFIELD, D.D.S., L.L.C.
Mailing Address - City:DAYVILLE
Mailing Address - State:CT
Mailing Address - Zip Code:06241
Mailing Address - Country:US
Mailing Address - Phone:860-779-1053
Mailing Address - Fax:860-779-7137
Practice Address - Street 1:1040 N. MAIN STREET
Practice Address - Street 2:KIMBAL SHEFFIELD, D.D.S., L.L.C.
Practice Address - City:DAYVILLE
Practice Address - State:CT
Practice Address - Zip Code:06241
Practice Address - Country:US
Practice Address - Phone:860-779-1053
Practice Address - Fax:860-779-7137
Is Sole Proprietor?:No
Enumeration Date:2008-11-12
Last Update Date:2012-04-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CT66291223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice