Provider Demographics
NPI:1184677387
Name:JONES, CHARLES PAUL (DDS)
Entity Type:Individual
Prefix:DR
First Name:CHARLES
Middle Name:PAUL
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 1:4019 COLUMBUS AVE
Mailing Address - Street 2:SUITE D
Mailing Address - City:ANDERSON
Mailing Address - State:IN
Mailing Address - Zip Code:46013-5069
Mailing Address - Country:US
Mailing Address - Phone:765-642-3100
Mailing Address - Fax:765-642-7222
Practice Address - Street 1:4019 COLUMBUS AVE
Practice Address - Street 2:SUITE D
Practice Address - City:ANDERSON
Practice Address - State:IN
Practice Address - Zip Code:46013-5069
Practice Address - Country:US
Practice Address - Phone:765-642-3100
Practice Address - Fax:765-642-7222
Is Sole Proprietor?:Not Answered
Enumeration Date:2006-05-18
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IN12007198A122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist