Provider Demographics
NPI:1609879048
Name:JONES, BRUCE ALLAN (DDS)
Entity Type:Individual
Prefix:DR
First Name:BRUCE
Middle Name:ALLAN
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 1:21605 HAWTHORNE BLVD
Mailing Address - Street 2:
Mailing Address - City:TORRANCE
Mailing Address - State:CA
Mailing Address - Zip Code:90503-6603
Mailing Address - Country:US
Mailing Address - Phone:310-540-4114
Mailing Address - Fax:310-316-9487
Practice Address - Street 1:21605 HAWTHORNE BLVD
Practice Address - Street 2:PAVILION C
Practice Address - City:TORRANCE
Practice Address - State:CA
Practice Address - Zip Code:90503-6603
Practice Address - Country:US
Practice Address - Phone:310-540-4114
Practice Address - Fax:310-316-9487
Is Sole Proprietor?:Not Answered
Enumeration Date:2005-05-31
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA229891223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice