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General NPI Number Information
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NPI Number | 1609978832
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Entity Type | Individual
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Provider Name | LUIS F JIMENEZ DMD
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Gender | Male
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Dates
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Enumeration Date | 09/01/2006
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Last Update Date | 07/08/2007
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Provider Practice Location Address
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Address Line | MARGINAL COSTA DE ORO C3 SUITE 12
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City | DORADO
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State | PR
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Zip | 00646
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Country | US
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Telephone | 787-796-7301
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Fax | 787-796-9672
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Provider Business Mailing Address
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Address Line | PO BOX 1029
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City | DORADO
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State | PR
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Zip | 00644-1029
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Country | US
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Telephone | 787-796-7301
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Fax | 787-796-9672
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 122300000X
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Taxonomy Name | Dentist
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License Number | 2115
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License Number State | PR
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