Individual
JIMMY HARDEN
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Contact information
Practice address
1283 SW ZESTY CIR APT 101, LAKE CITY, FL 32025-0729
(386) 344-4321
Mailing address
1283 SW ZESTY CIR APT 101, LAKE CITY, FL 32025-0729
(386) 344-4321
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
1223G00001X
FL
Other
Enumeration date
04/24/2014
Last updated
04/24/2014
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