Kimmes, Nicole Suzette

Kimmes, Nicole Suzette is an individual health care provider with primary practice located at 716 Stevens Ave , Portland ME 04103. She recently has only one registered license in Dental Providers / General Practice, which is considered as her primary health care specialty. Kimmes, Nicole Suzette can be contacted via phone (207) 221-4739.

Contact Information

Primary practice address
716 Stevens Ave Portland ME 04103
Phone: (207) 221-4739
Fax: (207) 523-1915
Website:
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Health care specialties

SpecialtyCodeLicense #State
Dental Providers / General Practice 1223G0001X DEN4481 Maine

Profile Details

NPI number 1285618413
LBN Legal business name Kimmes, Nicole Suzette
Credentials Doctor of Dental Surgery (DDS)
Entity Individual
Sole proprietor 1 No
Enumeration date Dec 1st, 2005
Last updated Jun 28th, 2018 - about 7 years ago

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

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Identifiers

StateTypeNumberIssuer
All States NPI 1285618413 NPPES
Nebraska MEDICAID 47071268413
Nebraska Other 7997

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