Provider Demographics
NPI:1396973061
Name:JONES, ELIZABETH COURTNEY (DMD)
Entity type:Individual
Prefix:DR
First Name:ELIZABETH
Middle Name:COURTNEY
Last Name:JONES
Suffix:
Gender:F
Credentials:DMD
Other - Prefix:
Other - First Name:ELIZABETH
Other - Middle Name:ANNE
Other - Last Name:COURTNEY
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:DMD
Mailing Address - Street 1:668 CENTRAL AVE
Mailing Address - Street 2:
Mailing Address - City:DOVER
Mailing Address - State:NH
Mailing Address - Zip Code:03820-3414
Mailing Address - Country:US
Mailing Address - Phone:603-749-3013
Mailing Address - Fax:603-749-2915
Practice Address - Street 1:668 CENTRAL AVE
Practice Address - Street 2:
Practice Address - City:DOVER
Practice Address - State:NH
Practice Address - Zip Code:03820-3414
Practice Address - Country:US
Practice Address - Phone:603-749-3013
Practice Address - Fax:603-749-2915
Is Sole Proprietor?:Yes
Enumeration Date:2009-07-01
Last Update Date:2014-04-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NH03944122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist
Provider Identifiers
StateIdentifier IDID TypeIssuer
NH33000057Medicaid