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General NPI Number Information
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NPI Number | 1700099280
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Entity Type | Organization
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Legal Business Name | LORI M. JIMISON, DDS, PC
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Dates
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Enumeration Date | 05/08/2007
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Last Update Date | 08/22/2020
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Provider Practice Location Address
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Address Line | 3013 TAFT AVE SUITE #2
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City | LOVELAND
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State | CO
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Zip | 80538-2571
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Country | US
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Telephone | 970-667-6943
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Fax | 970-667-7339
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Provider Business Mailing Address
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Address Line | 3013 TAFT AVE SUITE #2
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City | LOVELAND
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State | CO
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Zip | 80538-2571
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Country | US
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Telephone | 970-667-6943
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Fax | 970-667-7339
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Authorized Official
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Title or Position | PRESIDENT
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Name | DR. LORI MAE JIMISON
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Credential | D.D.S.
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Telephone | 970-663-6868
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 1223G0001X
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Taxonomy Name | General Practice Dentistry
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License Number | 7479
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License Number State | CO
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