Provider Demographics
NPI:1740339654
Name:JONES, KATHERINE MARIE (DDS)
Entity type:Individual
Prefix:
First Name:KATHERINE
Middle Name:MARIE
Last Name:JONES
Suffix:
Gender:F
Credentials:DDS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1620 S PADRE ISLAND DR
Mailing Address - Street 2:SUITE 250
Mailing Address - City:CORPUS CHRISTI
Mailing Address - State:TX
Mailing Address - Zip Code:78416-1353
Mailing Address - Country:US
Mailing Address - Phone:361-853-7156
Mailing Address - Fax:
Practice Address - Street 1:1620 S PADRE ISLAND DR
Practice Address - Street 2:SUITE 250
Practice Address - City:CORPUS CHRISTI
Practice Address - State:TX
Practice Address - Zip Code:78416-1353
Practice Address - Country:US
Practice Address - Phone:361-853-7156
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-01-09
Last Update Date:2014-07-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA400801223G0001X
TX298731223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice