Provider Demographics
NPI:1750343844
Name:FEE, KIMBERLY WEEKS (DMD)
Entity type:Individual
Prefix:DR
First Name:KIMBERLY
Middle Name:WEEKS
Last Name:FEE
Suffix:
Gender:F
Credentials:DMD
Other - Prefix:DR
Other - First Name:KIMBERLY
Other - Middle Name:WEEKS
Other - Last Name:GOODWIN
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:DMD
Mailing Address - Street 1:2350 LE LOUP DR
Mailing Address - Street 2:
Mailing Address - City:PRESCOTT
Mailing Address - State:AZ
Mailing Address - Zip Code:86305-2139
Mailing Address - Country:US
Mailing Address - Phone:928-778-6716
Mailing Address - Fax:
Practice Address - Street 1:1316 W GURLEY ST
Practice Address - Street 2:
Practice Address - City:PRESCOTT
Practice Address - State:AZ
Practice Address - Zip Code:86305-2854
Practice Address - Country:US
Practice Address - Phone:928-778-7410
Practice Address - Fax:928-771-1157
Is Sole Proprietor?:Not Answered
Enumeration Date:2006-04-04
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AZAZ37721223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice