Individual
KERIANN JIMENEZ
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
520 N 12TH ST, RICHMOND, VA 23298-5064
(703) 608-7893
Mailing address
5609 QUALLA FARMS CT, CHESTERFIELD, VA 23832-4059
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
0401418936
VA
1223G0001X
General Practice Dentistry
DN122992
GA
Other
Enumeration date
06/13/2022
Last updated
07/23/2024
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