Provider Demographics
NPI:1316031875
Name:JONES, BRANT CHANDLER (DMD)
Entity Type:Individual
Prefix:DR
First Name:BRANT
Middle Name:CHANDLER
Last Name:JONES
Suffix:
Gender:M
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:PO BOX 7325
Mailing Address - Street 2:
Mailing Address - City:LACONIA
Mailing Address - State:NH
Mailing Address - Zip Code:03247-7325
Mailing Address - Country:US
Mailing Address - Phone:603-524-8250
Mailing Address - Fax:
Practice Address - Street 1:25 COUNTRY CLUB RD
Practice Address - Street 2:VILLAGE WEST ONE BLDG 4
Practice Address - City:GILFORD
Practice Address - State:NH
Practice Address - Zip Code:03249-6972
Practice Address - Country:US
Practice Address - Phone:603-524-8250
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-10-02
Last Update Date:2009-12-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NH037211223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice