Provider Demographics
NPI:1154813954
Name:JONES, CHANDLER JEAN (DMD)
Entity Type:Individual
Prefix:
First Name:CHANDLER
Middle Name:JEAN
Last Name:JONES
Suffix:
Gender:F
Credentials:DMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:315 MINER AVE W
Mailing Address - Street 2:
Mailing Address - City:LADYSMITH
Mailing Address - State:WI
Mailing Address - Zip Code:54848-1725
Mailing Address - Country:US
Mailing Address - Phone:715-532-2500
Mailing Address - Fax:715-532-9606
Practice Address - Street 1:315 MINER AVE W
Practice Address - Street 2:
Practice Address - City:LADYSMITH
Practice Address - State:WI
Practice Address - Zip Code:54848-1725
Practice Address - Country:US
Practice Address - Phone:715-532-2500
Practice Address - Fax:715-532-9606
Is Sole Proprietor?:No
Enumeration Date:2018-06-06
Last Update Date:2023-06-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WI1001844-151223D0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223D0001XDental ProvidersDentistDental Public Health