Individual
DR. JONATHAN BRIAN GRIMES
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
DDS
Contact information
Practice address
4 OLD KINGS RD N STE A, PALM COAST, FL 32137-8293
(386) 445-1234
Mailing address
70 FAIRBANK LN, PALM COAST, FL 32137-9159
Taxonomy
Speciality
Code
Description
License number
State
122300000X
Dentist
Primary
25715
FL
Other
Enumeration date
06/28/2017
Last updated
08/18/2023
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