Provider Demographics
NPI:1043387434
Name:JONES, RICHARD E (DDS, MSD)
Entity Type:Individual
Prefix:DR
First Name:RICHARD
Middle Name:E
Last Name:JONES
Suffix:
Gender:M
Credentials:DDS, MSD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:9333 CALUMET AVE
Mailing Address - Street 2:D
Mailing Address - City:MUNSTER
Mailing Address - State:IN
Mailing Address - Zip Code:46321-2809
Mailing Address - Country:US
Mailing Address - Phone:219-836-4214
Mailing Address - Fax:219-836-5205
Practice Address - Street 1:9333 CALUMET AVE
Practice Address - Street 2:D
Practice Address - City:MUNSTER
Practice Address - State:IN
Practice Address - Zip Code:46321-2809
Practice Address - Country:US
Practice Address - Phone:219-836-4214
Practice Address - Fax:219-836-5205
Is Sole Proprietor?:Yes
Enumeration Date:2006-11-29
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IN12007251B1223P0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223P0700XDental ProvidersDentistProsthodontics