Individual
JOSEPH MIGUEL JIMENEZ
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Contact information
Practice address
1064 7 LAKES DR, WEST END, NC 27376-9081
(910) 673-6030
Mailing address
1064 7 LAKES DR, WEST END, NC 27376-9081
(910) 673-6030
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
10850
SC
1223G0001X
General Practice Dentistry
Primary
14139
NC
390200000X
Student in an Organized Health Care Education/Training Program
—
—
Other
Enumeration date
04/03/2023
Last updated
07/14/2025
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