Provider Demographics
NPI:1902001084
Name:JONES-HARRY, EUGENIA J (DMD, MAGD)
Entity Type:Individual
Prefix:DR
First Name:EUGENIA
Middle Name:J
Last Name:JONES-HARRY
Suffix:
Gender:F
Credentials:DMD, MAGD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:134 WINDRIDGE
Mailing Address - Street 2:
Mailing Address - City:LAGRANGE
Mailing Address - State:GA
Mailing Address - Zip Code:30240-9743
Mailing Address - Country:US
Mailing Address - Phone:706-884-3290
Mailing Address - Fax:706-884-9404
Practice Address - Street 1:1602 VERNON RD
Practice Address - Street 2:SUITE 100
Practice Address - City:LAGRANGE
Practice Address - State:GA
Practice Address - Zip Code:30240-4129
Practice Address - Country:US
Practice Address - Phone:706-885-9991
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-06-18
Last Update Date:2008-12-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GA105521223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice