Provider Demographics
NPI:1629353792
Name:JONES, MAURY-ANNE
Entity Type:Individual
Prefix:
First Name:MAURY-ANNE
Middle Name:
Last Name:JONES
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:265 CENTRE RD
Mailing Address - Street 2:
Mailing Address - City:WALES
Mailing Address - State:ME
Mailing Address - Zip Code:04280-3306
Mailing Address - Country:US
Mailing Address - Phone:207-212-8298
Mailing Address - Fax:207-513-1197
Practice Address - Street 1:19 PETTINGILL ST
Practice Address - Street 2:
Practice Address - City:LEWISTON
Practice Address - State:ME
Practice Address - Zip Code:04240-5903
Practice Address - Country:US
Practice Address - Phone:207-513-1111
Practice Address - Fax:207-513-1197
Is Sole Proprietor?:No
Enumeration Date:2011-10-20
Last Update Date:2011-10-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
ME3793124Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes124Q00000XDental ProvidersDental Hygienist