Provider Demographics
NPI:1114729050
Name:KIMBALL & BEECHER GROUP LLC
Entity type:Organization
Organization Name:KIMBALL & BEECHER GROUP LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CONTROLLER
Authorized Official - Prefix:
Authorized Official - First Name:SANDY
Authorized Official - Middle Name:MARIE
Authorized Official - Last Name:CROCK
Authorized Official - Suffix:
Authorized Official - Credentials:RDH
Authorized Official - Phone:319-235-6287
Mailing Address - Street 1:4015 HURST DR
Mailing Address - Street 2:
Mailing Address - City:WATERLOO
Mailing Address - State:IA
Mailing Address - Zip Code:50701-9035
Mailing Address - Country:US
Mailing Address - Phone:319-235-6287
Mailing Address - Fax:563-293-2495
Practice Address - Street 1:106 E WASHINGTON AVE
Practice Address - Street 2:
Practice Address - City:FAIRFIELD
Practice Address - State:IA
Practice Address - Zip Code:52556-3326
Practice Address - Country:US
Practice Address - Phone:641-472-3147
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:KIMBALL & BEECHER GROUP LLC
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2025-03-24
Last Update Date:2025-04-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1223G0001XDental ProvidersDentistGeneral PracticeGroup - Multi-Specialty