Provider Demographics
NPI:1114313277
Name:JONES, LORIE (RDH, BSDH, MBA)
Entity Type:Individual
Prefix:
First Name:LORIE
Middle Name:
Last Name:JONES
Suffix:
Gender:F
Credentials:RDH, BSDH, MBA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:6315-B FM 1488 #240
Mailing Address - Street 2:
Mailing Address - City:MAGNOLIA
Mailing Address - State:TX
Mailing Address - Zip Code:77354-2248
Mailing Address - Country:US
Mailing Address - Phone:800-707-0747
Mailing Address - Fax:
Practice Address - Street 1:6315-B FM 1488 #240
Practice Address - Street 2:
Practice Address - City:MAGNOLIA
Practice Address - State:TX
Practice Address - Zip Code:77354-7735
Practice Address - Country:US
Practice Address - Phone:800-707-0747
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2015-04-15
Last Update Date:2023-04-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX11880124Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes124Q00000XDental ProvidersDental Hygienist