Provider Demographics
NPI:1467555136
Name:JONES, CHRISTOPHER EDWIN (DDS)
Entity Type:Individual
Prefix:DR
First Name:CHRISTOPHER
Middle Name:EDWIN
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 1:2401 N TRAIL RD
Mailing Address - Street 2:
Mailing Address - City:MIDLAND
Mailing Address - State:MI
Mailing Address - Zip Code:48642-8841
Mailing Address - Country:US
Mailing Address - Phone:989-430-7753
Mailing Address - Fax:989-835-5656
Practice Address - Street 1:6118 MERLIN CT
Practice Address - Street 2:
Practice Address - City:MIDLAND
Practice Address - State:MI
Practice Address - Zip Code:48640-7358
Practice Address - Country:US
Practice Address - Phone:989-430-7753
Practice Address - Fax:989-835-5656
Is Sole Proprietor?:Yes
Enumeration Date:2006-09-07
Last Update Date:2015-10-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI29010152651223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice