Individual
SYLVIA G JIMENEZ
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
DDS
Contact information
Practice address
11398 SE 82ND AVE, STE 802, CLACKAMAS, OR 97086-7637
(503) 513-6000
Mailing address
11398 SE 82ND AVE, STE 802, CLACKAMAS, OR 97086-7637
(503) 513-6000
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
D9979
OR
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
6393
DDS LICENSE #
AZ
Enumeration date
04/04/2007
Last updated
12/27/2013
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