Provider Demographics
NPI:1982728366
Name:JONES, STEVEN MICHAEL (DDS)
Entity Type:Individual
Prefix:DR
First Name:STEVEN
Middle Name:MICHAEL
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:PO BOX 235
Mailing Address - Street 2:
Mailing Address - City:GLASGOW
Mailing Address - State:MO
Mailing Address - Zip Code:65254-0235
Mailing Address - Country:US
Mailing Address - Phone:660-338-2277
Mailing Address - Fax:660-338-2277
Practice Address - Street 1:108 SCENIC DR
Practice Address - Street 2:
Practice Address - City:GLASGOW
Practice Address - State:MO
Practice Address - Zip Code:65254-0235
Practice Address - Country:US
Practice Address - Phone:660-338-2277
Practice Address - Fax:660-338-2277
Is Sole Proprietor?:No
Enumeration Date:2007-03-19
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MO123671223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice