Individual
ESTHER JIMENEZ
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
D.D.S
Contact information
Practice address
2755 FULLER AVE NE, GRAND RAPIDS, MI 49505-3780
(616) 363-1136
(616) 363-4345
Mailing address
2755 FULLER AVE NE, GRAND RAPIDS, MI 49505-3780
(616) 363-1136
(616) 363-4845
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
2901016615
MI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
4085599
—
MI
05
—
4525364
—
MI
Enumeration date
08/16/2006
Last updated
04/14/2008
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