Individual
MIRANDA ALISE JIMENEZ
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
DDS
Contact information
Practice address
2121 SUMMIT ST, KANSAS CITY, MO 64108-2126
(816) 429-2145
Mailing address
2121 SUMMIT ST, KANSAS CITY, MO 64108-2126
(816) 983-5937
Taxonomy
Speciality
Code
Description
License number
State
122300000X
Dentist
Primary
2017021249
MO
Other
Enumeration date
06/23/2017
Last updated
10/05/2018
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