Provider Demographics
NPI:1730497587
Name:JONES, STEPHEN BARRETT (DMD)
Entity Type:Individual
Prefix:DR
First Name:STEPHEN
Middle Name:BARRETT
Last Name:JONES
Suffix:
Gender:M
Credentials:DMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:163A GOLF COURSE LANE
Mailing Address - Street 2:
Mailing Address - City:MOUNTAIN CITY
Mailing Address - State:TN
Mailing Address - Zip Code:37683
Mailing Address - Country:US
Mailing Address - Phone:423-727-6196
Mailing Address - Fax:
Practice Address - Street 1:5249 HWY 67W
Practice Address - Street 2:NORTHEAST CORRECTIONAL CENTER
Practice Address - City:MOUNTAIN CITY
Practice Address - State:TN
Practice Address - Zip Code:37683-0000
Practice Address - Country:US
Practice Address - Phone:423-727-7387
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2010-09-15
Last Update Date:2010-09-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TN8764122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist