Provider Demographics
NPI:1710013255
Name:LARRY DON JONES DDS INC.
Entity Type:Organization
Organization Name:LARRY DON JONES DDS INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:LARRY
Authorized Official - Middle Name:DON
Authorized Official - Last Name:JONES
Authorized Official - Suffix:
Authorized Official - Credentials:DDS
Authorized Official - Phone:512-446-2535
Mailing Address - Street 1:302 MEADOW DR
Mailing Address - Street 2:
Mailing Address - City:ROCKDALE
Mailing Address - State:TX
Mailing Address - Zip Code:76567-2644
Mailing Address - Country:US
Mailing Address - Phone:512-446-2535
Mailing Address - Fax:512-446-3706
Practice Address - Street 1:302 MEADOW DR
Practice Address - Street 2:
Practice Address - City:ROCKDALE
Practice Address - State:TX
Practice Address - Zip Code:76567-2644
Practice Address - Country:US
Practice Address - Phone:512-446-2535
Practice Address - Fax:512-446-3706
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-02-26
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX11825261QD0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QD0000XAmbulatory Health Care FacilitiesClinic/CenterDental