Provider Demographics
NPI:1487647350
Name:JONES, BROOK W (DDS)
Entity Type:Individual
Prefix:DR
First Name:BROOK
Middle Name:W
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 1:1705 DOBELL RD
Mailing Address - Street 2:
Mailing Address - City:PERRIS
Mailing Address - State:CA
Mailing Address - Zip Code:92571-6502
Mailing Address - Country:US
Mailing Address - Phone:951-657-7366
Mailing Address - Fax:
Practice Address - Street 1:1ST DENBN NDC
Practice Address - Street 2:BOX 555221
Practice Address - City:CAMP PENDLETON
Practice Address - State:CA
Practice Address - Zip Code:92055-5221
Practice Address - Country:US
Practice Address - Phone:760-725-5578
Practice Address - Fax:
Is Sole Proprietor?:Not Answered
Enumeration Date:2005-08-25
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AZD6454122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist