Provider Demographics
NPI:1851394514
Name:JONES, ROGER C (DDS)
Entity Type:Individual
Prefix:DR
First Name:ROGER
Middle Name:C
Last Name:JONES
Suffix:
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 1:3628 MERIDIAN ST
Mailing Address - Street 2:STE 1A
Mailing Address - City:BELLINGHAM
Mailing Address - State:WA
Mailing Address - Zip Code:98225-1735
Mailing Address - Country:US
Mailing Address - Phone:360-676-9660
Mailing Address - Fax:360-676-9414
Practice Address - Street 1:3628 MERIDIAN ST
Practice Address - Street 2:STE 1A
Practice Address - City:BELLINGHAM
Practice Address - State:WA
Practice Address - Zip Code:98225-1735
Practice Address - Country:US
Practice Address - Phone:360-676-9660
Practice Address - Fax:360-676-9414
Is Sole Proprietor?:Yes
Enumeration Date:2005-05-24
Last Update Date:2019-08-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WA42241223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice