Provider Demographics
NPI:1376744987
Name:RICHARD S JONES DMD PC
Entity Type:Organization
Organization Name:RICHARD S JONES DMD PC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRES.
Authorized Official - Prefix:DR
Authorized Official - First Name:RICHARD
Authorized Official - Middle Name:SHEPHERD
Authorized Official - Last Name:JONES
Authorized Official - Suffix:
Authorized Official - Credentials:DMD
Authorized Official - Phone:570-586-8900
Mailing Address - Street 1:426 MULBERRY ST
Mailing Address - Street 2:STE 201
Mailing Address - City:SCRANTON
Mailing Address - State:PA
Mailing Address - Zip Code:18503-1509
Mailing Address - Country:US
Mailing Address - Phone:570-347-6701
Mailing Address - Fax:570-347-5062
Practice Address - Street 1:239 NORTHERN BLVD, SUITE 7
Practice Address - Street 2:
Practice Address - City:CLARKS SUMMIT
Practice Address - State:PA
Practice Address - Zip Code:18411
Practice Address - Country:US
Practice Address - Phone:570-586-8900
Practice Address - Fax:570-586-8912
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-05-30
Last Update Date:2013-06-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PADS0167311223P0300X
PADS016731L1223P0300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1223P0300XDental ProvidersDentistPeriodonticsGroup - Single Specialty