Provider Demographics
NPI:1831305549
Name:JONES, H. DOUGLAS JR (DDS)
Entity Type:Individual
Prefix:
First Name:H.
Middle Name:DOUGLAS
Last Name:JONES
Suffix:JR
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 1:1552 EDGEMERE DR
Mailing Address - Street 2:
Mailing Address - City:ROCHESTER
Mailing Address - State:NY
Mailing Address - Zip Code:14612-1514
Mailing Address - Country:US
Mailing Address - Phone:585-225-5496
Mailing Address - Fax:
Practice Address - Street 1:4415 BUFFALO RD
Practice Address - Street 2:STE. 10
Practice Address - City:NORTH CHILI
Practice Address - State:NY
Practice Address - Zip Code:14514-1024
Practice Address - Country:US
Practice Address - Phone:585-594-4334
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-05-16
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY026465122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist