Individual
CHRISTIAN JIMENEZ
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
DMD
Contact information
Practice address
516 MARY ESTHER CUT OFF NW STE 2, FORT WALTON BEACH, FL 32548-4025
(850) 460-3221
Mailing address
127 COVEWOOD WAY APT 101, SANTA ROSA BEACH, FL 32459-2671
(443) 345-7705
Taxonomy
Speciality
Code
Description
License number
State
1223S0112X
Oral and Maxillofacial Surgery (Dentist)
13149
CT
1223S0112X
Oral and Maxillofacial Surgery (Dentist)
Primary
25505
FL
Other
Enumeration date
04/15/2020
Last updated
07/02/2024
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