Provider Demographics
NPI:1144398108
Name:JONES, DAVID CHURCHILL (DDS)
Entity Type:Individual
Prefix:DR
First Name:DAVID
Middle Name:CHURCHILL
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 1:25 CLEVELAND AVE
Mailing Address - Street 2:SUITE E
Mailing Address - City:MARTINSVILLE
Mailing Address - State:VA
Mailing Address - Zip Code:24112-2935
Mailing Address - Country:US
Mailing Address - Phone:276-638-8888
Mailing Address - Fax:
Practice Address - Street 1:25 CLEVELAND AVE
Practice Address - Street 2:SUITE E
Practice Address - City:MARTINSVILLE
Practice Address - State:VA
Practice Address - Zip Code:24112-2935
Practice Address - Country:US
Practice Address - Phone:276-638-8888
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2006-11-30
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA50691223X0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223X0400XDental ProvidersDentistOrthodontics and Dentofacial Orthopedics