Provider Demographics
NPI:1336458397
Name:JONES, WESTON KEITH (DMD)
Entity Type:Individual
Prefix:DR
First Name:WESTON
Middle Name:KEITH
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 1:1208 HILLTOP DR STE 209
Mailing Address - Street 2:
Mailing Address - City:ROCK SPRINGS
Mailing Address - State:WY
Mailing Address - Zip Code:82901-5860
Mailing Address - Country:US
Mailing Address - Phone:307-362-3395
Mailing Address - Fax:
Practice Address - Street 1:1208 HILLTOP DR STE 209
Practice Address - Street 2:
Practice Address - City:ROCK SPRINGS
Practice Address - State:WY
Practice Address - Zip Code:82901-5860
Practice Address - Country:US
Practice Address - Phone:307-362-3395
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2010-09-24
Last Update Date:2016-09-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX259931223P0221X
WY14571223P0221X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223P0221XDental ProvidersDentistPediatric Dentistry