Provider Demographics
NPI:1972254951
Name:DR CARLOS M JONES FAMILY DENTAL CENTER PC
Entity Type:Organization
Organization Name:DR CARLOS M JONES FAMILY DENTAL CENTER PC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OFFICE MANAGER
Authorized Official - Prefix:
Authorized Official - First Name:ANGELO
Authorized Official - Middle Name:
Authorized Official - Last Name:JONES
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:313-530-8737
Mailing Address - Street 1:14807 W MCNICHOLS RD
Mailing Address - Street 2:
Mailing Address - City:DETROIT
Mailing Address - State:MI
Mailing Address - Zip Code:48235-3939
Mailing Address - Country:US
Mailing Address - Phone:313-493-0110
Mailing Address - Fax:313-493-1121
Practice Address - Street 1:14807 W MCNICHOLS RD
Practice Address - Street 2:
Practice Address - City:DETROIT
Practice Address - State:MI
Practice Address - Zip Code:48235-3939
Practice Address - Country:US
Practice Address - Phone:313-493-0110
Practice Address - Fax:313-493-1121
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2022-01-12
Last Update Date:2022-01-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1223G0001XDental ProvidersDentistGeneral PracticeGroup - Single Specialty