Individual
DR. JONATHAN LEE MIMS
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
DMD
Contact information
Practice address
371 WHITNEY RD, SPARTANBURG, SC 29303-3143
(864) 515-0485
Mailing address
201 W 8TH ST, SUITE 810, PUEBLO, CO 81003-3038
(719) 562-4447
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
4052
SC
Other
Enumeration date
04/12/2007
Last updated
12/29/2010
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