Provider Demographics
NPI:1639242753
Name:JONES, BRUCE EMERSON (DDS)
Entity type:Individual
Prefix:DR
First Name:BRUCE
Middle Name:EMERSON
Last Name:JONES
Suffix:
Gender:M
Credentials:DDS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:430 LOCUST ST
Mailing Address - Street 2:P.O. BOX 885
Mailing Address - City:JEFFERSONVILLE
Mailing Address - State:IN
Mailing Address - Zip Code:47130-3418
Mailing Address - Country:US
Mailing Address - Phone:812-288-8131
Mailing Address - Fax:812-280-7184
Practice Address - Street 1:430 LOCUST ST
Practice Address - Street 2:
Practice Address - City:JEFFERSONVILLE
Practice Address - State:IN
Practice Address - Zip Code:47130-3418
Practice Address - Country:US
Practice Address - Phone:812-288-8131
Practice Address - Fax:812-280-7184
Is Sole Proprietor?:Yes
Enumeration Date:2006-11-16
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IN67201223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice