Provider Demographics
NPI:1487798450
Name:ARNOLD, KIMBERLY ANN (DMD)
Entity type:Individual
Prefix:DR
First Name:KIMBERLY
Middle Name:ANN
Last Name:ARNOLD
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:PO BOX 356
Mailing Address - Street 2:
Mailing Address - City:CATLETTSBURG
Mailing Address - State:KY
Mailing Address - Zip Code:41129-0356
Mailing Address - Country:US
Mailing Address - Phone:606-739-5151
Mailing Address - Fax:606-739-4301
Practice Address - Street 1:3161 OAKLAND AVE
Practice Address - Street 2:
Practice Address - City:CATLETTSBURG
Practice Address - State:KY
Practice Address - Zip Code:41129-1155
Practice Address - Country:US
Practice Address - Phone:606-739-5151
Practice Address - Fax:606-739-4301
Is Sole Proprietor?:No
Enumeration Date:2007-02-16
Last Update Date:2010-02-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KY67991223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice
Provider Identifiers
StateIdentifier IDID TypeIssuer
4055956OtherBCBS ID
537849OtherUNITED CONCORDIA ID