Provider Demographics
NPI:1891904637
Name:R, W. JONES DDS, PC
Entity Type:Organization
Organization Name:R, W. JONES DDS, PC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:ROBERT
Authorized Official - Middle Name:WILLIAM
Authorized Official - Last Name:JONES
Authorized Official - Suffix:
Authorized Official - Credentials:DDS
Authorized Official - Phone:989-288-2669
Mailing Address - Street 1:106 N MARQUETTE ST
Mailing Address - Street 2:P. O. BOX 228
Mailing Address - City:DURAND
Mailing Address - State:MI
Mailing Address - Zip Code:48429-1423
Mailing Address - Country:US
Mailing Address - Phone:989-288-2669
Mailing Address - Fax:989-288-2660
Practice Address - Street 1:106 N MARQUETTE ST
Practice Address - Street 2:
Practice Address - City:DURAND
Practice Address - State:MI
Practice Address - Zip Code:48429-1423
Practice Address - Country:US
Practice Address - Phone:989-288-2669
Practice Address - Fax:989-288-2660
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-05-21
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI8064122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes122300000XDental ProvidersDentistGroup - Single Specialty