Provider Demographics
NPI:1669597399
Name:TAUBER, KIMBERLY (DMD)
Entity type:Individual
Prefix:DR
First Name:KIMBERLY
Middle Name:
Last Name:TAUBER
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 1:6 STRATTON CT
Mailing Address - Street 2:
Mailing Address - City:SPARTA
Mailing Address - State:NJ
Mailing Address - Zip Code:07871-1538
Mailing Address - Country:US
Mailing Address - Phone:973-729-2242
Mailing Address - Fax:
Practice Address - Street 1:59 E MILL RD
Practice Address - Street 2:SUTIE 2-2034
Practice Address - City:LONG VALLEY
Practice Address - State:NJ
Practice Address - Zip Code:07853-6215
Practice Address - Country:US
Practice Address - Phone:908-876-5225
Practice Address - Fax:908-876-1062
Is Sole Proprietor?:No
Enumeration Date:2007-03-20
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ022838001223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice