Provider Demographics
NPI:1942436217
Name:JONES, ERIC WONDERLY (DMD)
Entity Type:Individual
Prefix:DR
First Name:ERIC
Middle Name:WONDERLY
Last Name:JONES
Suffix:
Gender:M
Credentials:DMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:7338 SPOUT SPRINGS RD
Mailing Address - Street 2:SUITE C-15
Mailing Address - City:FLOWERY BRANCH
Mailing Address - State:GA
Mailing Address - Zip Code:30542-5803
Mailing Address - Country:US
Mailing Address - Phone:910-750-4277
Mailing Address - Fax:
Practice Address - Street 1:7338 SPOUT SPRINGS RD
Practice Address - Street 2:SUITE C-15
Practice Address - City:FLOWERY BRANCH
Practice Address - State:GA
Practice Address - Zip Code:30542-5803
Practice Address - Country:US
Practice Address - Phone:910-750-4277
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2009-06-01
Last Update Date:2011-08-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC87891223G0001X
GADN0142851223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice