Provider Demographics
NPI:1205955283
Name:JONES, DANA HAL (DMD,PA)
Entity type:Individual
Prefix:DR
First Name:DANA
Middle Name:HAL
Last Name:JONES
Suffix:
Gender:M
Credentials:DMD,PA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 1300
Mailing Address - Street 2:
Mailing Address - City:KILN
Mailing Address - State:MS
Mailing Address - Zip Code:39556-1300
Mailing Address - Country:US
Mailing Address - Phone:228-255-0882
Mailing Address - Fax:228-255-0846
Practice Address - Street 1:17094 HWY 603
Practice Address - Street 2:
Practice Address - City:KILN
Practice Address - State:MS
Practice Address - Zip Code:39556
Practice Address - Country:US
Practice Address - Phone:228-255-0882
Practice Address - Fax:228-255-0846
Is Sole Proprietor?:No
Enumeration Date:2007-03-28
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MS2021831223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice