Provider Demographics
NPI:1649695552
Name:JONES, JOSEPH REUBEN (DMD)
Entity type:Individual
Prefix:DR
First Name:JOSEPH
Middle Name:REUBEN
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 1:101 WILDWOOD CT
Mailing Address - Street 2:
Mailing Address - City:ATHENS
Mailing Address - State:GA
Mailing Address - Zip Code:30606-4956
Mailing Address - Country:US
Mailing Address - Phone:706-206-0350
Mailing Address - Fax:
Practice Address - Street 1:2220 WISTERIA DR STE 300
Practice Address - Street 2:
Practice Address - City:SNELLVILLE
Practice Address - State:GA
Practice Address - Zip Code:30078
Practice Address - Country:US
Practice Address - Phone:678-836-2107
Practice Address - Fax:770-643-4303
Is Sole Proprietor?:No
Enumeration Date:2014-02-28
Last Update Date:2018-11-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GADN0148261223X0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223X0400XDental ProvidersDentistOrthodontics and Dentofacial Orthopedics