Provider Demographics
NPI:1437616349
Name:DAGON JONES DDS INC.
Entity Type:Organization
Organization Name:DAGON JONES DDS INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:DAGON
Authorized Official - Middle Name:HURRICANE CASEY
Authorized Official - Last Name:JONES
Authorized Official - Suffix:
Authorized Official - Credentials:DDS
Authorized Official - Phone:530-756-5300
Mailing Address - Street 1:2800 5TH STREET
Mailing Address - Street 2:SUITE 100
Mailing Address - City:DAVIS
Mailing Address - State:CA
Mailing Address - Zip Code:95618
Mailing Address - Country:US
Mailing Address - Phone:530-756-5300
Mailing Address - Fax:530-756-4941
Practice Address - Street 1:2800 5TH STREET
Practice Address - Street 2:SUITE 100
Practice Address - City:DAVIS
Practice Address - State:CA
Practice Address - Zip Code:95618
Practice Address - Country:US
Practice Address - Phone:530-756-5300
Practice Address - Fax:530-756-4941
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2019-02-27
Last Update Date:2019-02-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes122300000XDental ProvidersDentistGroup - Single Specialty