Provider Demographics
NPI:1487726956
Name:TOWNES, KIMBERLY (D,D,S)
Entity type:Individual
Prefix:DR
First Name:KIMBERLY
Middle Name:
Last Name:TOWNES
Suffix:
Gender:F
Credentials:D,D,S
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3527 PINEY WOODS PL
Mailing Address - Street 2:H 304
Mailing Address - City:LAUREL
Mailing Address - State:MD
Mailing Address - Zip Code:20724-6025
Mailing Address - Country:US
Mailing Address - Phone:410-908-3779
Mailing Address - Fax:
Practice Address - Street 1:3223 DUKE ST
Practice Address - Street 2:SUITE A
Practice Address - City:ALEXANDRIA
Practice Address - State:VA
Practice Address - Zip Code:22314-4586
Practice Address - Country:US
Practice Address - Phone:703-212-0602
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-11-14
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA04014110211223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice