Thomas, Kimberly

Thomas, Kimberly is an individual health care provider with primary practice located at 6404 Roosevelt Blvd , Philadelphia PA 19149-2943. She recently has only one registered license in Dental Providers / Pediatric Dentistry, which is considered as her primary health care specialty. Thomas, Kimberly can be contacted via phone (215) 743-3700.

Contact Information

Primary practice address
6404 Roosevelt Blvd Philadelphia PA 19149-2943
Fax: (215) 743-3706
Website:

Health care specialties

SpecialtyCodeLicense #State
Dental Providers / Pediatric Dentistry 1223P0221X DS029815L Pennsylvania

Profile Details

NPI number 1285628040
LBN Legal business name Thomas, Kimberly
Credentials Doctor of Dental Medicine (DMD)
Entity Individual
Sole proprietor 1 No
Enumeration date Sep 8th, 2005
Last updated Mar 29th, 2012 - about 13 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 1285628040 NPPES
Pennsylvania MEDICAID 001963800

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