Provider Demographics
NPI:1760981120
Name:L. JONES-DOVE & ASSOCIATES TOOTH SPA LLC
Entity Type:Organization
Organization Name:L. JONES-DOVE & ASSOCIATES TOOTH SPA LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT/CEO
Authorized Official - Prefix:DR
Authorized Official - First Name:LYNETTE
Authorized Official - Middle Name:RENEE
Authorized Official - Last Name:JONES-DOVE
Authorized Official - Suffix:
Authorized Official - Credentials:DDS
Authorized Official - Phone:301-345-5656
Mailing Address - Street 1:6103 GREENBELT ROAD
Mailing Address - Street 2:
Mailing Address - City:COLLEGE PARK
Mailing Address - State:MD
Mailing Address - Zip Code:20740
Mailing Address - Country:US
Mailing Address - Phone:301-345-5656
Mailing Address - Fax:301-345-0286
Practice Address - Street 1:6103 GREENBELT ROAD
Practice Address - Street 2:
Practice Address - City:COLLEGE PARK
Practice Address - State:MD
Practice Address - Zip Code:20740
Practice Address - Country:US
Practice Address - Phone:301-345-5656
Practice Address - Fax:301-345-0286
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2018-02-12
Last Update Date:2018-02-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1223G0001XDental ProvidersDentistGeneral PracticeGroup - Single Specialty