Provider Demographics
NPI:1649310624
Name:BROWN LOOSMANN, KIMBERLY (DMD)
Entity type:Individual
Prefix:
First Name:KIMBERLY
Middle Name:
Last Name:BROWN LOOSMANN
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 1:19 PISCASSIC RD
Mailing Address - Street 2:
Mailing Address - City:NEWFIELDS
Mailing Address - State:NH
Mailing Address - Zip Code:03856-8206
Mailing Address - Country:US
Mailing Address - Phone:603-772-6809
Mailing Address - Fax:
Practice Address - Street 1:61 ROUTE #27
Practice Address - Street 2:
Practice Address - City:RAYMOND
Practice Address - State:NH
Practice Address - Zip Code:03077
Practice Address - Country:US
Practice Address - Phone:603-895-5600
Practice Address - Fax:603-895-8887
Is Sole Proprietor?:No
Enumeration Date:2007-02-07
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NH2644122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist