Provider Demographics
NPI:1114003233
Name:JONES, STEPHEN BLAIR (DDS)
Entity Type:Individual
Prefix:DR
First Name:STEPHEN
Middle Name:BLAIR
Last Name:JONES
Suffix:
Gender:M
Credentials:DDS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1700 COUNTRY CLUB DR
Mailing Address - Street 2:SUITE A
Mailing Address - City:MANSFIELD
Mailing Address - State:TX
Mailing Address - Zip Code:76063-2615
Mailing Address - Country:US
Mailing Address - Phone:817-473-6227
Mailing Address - Fax:817-463-6919
Practice Address - Street 1:1700 COUNTRY CLUB DR
Practice Address - Street 2:SUITE A
Practice Address - City:MANSFIELD
Practice Address - State:TX
Practice Address - Zip Code:76063-2615
Practice Address - Country:US
Practice Address - Phone:817-473-6227
Practice Address - Fax:817-463-6919
Is Sole Proprietor?:Yes
Enumeration Date:2006-10-31
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX137621223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice