Healthcare Provider Details

I. General information

NPI: 1003369125
Provider Name (Legal Business Name): ALAN MAX JONES DMD
Entity Type: Individual
Gender: Male
Sole Proprietor: N

Provider Other Name: ALAN MAX JONES DMD

II. Dates (important events)

Enumeration Date: 07/25/2016
Last Update Date: 08/04/2026
Certification Date: 08/04/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

518 LOWER GLASS BRIDGE RD
LAGRANGE GA
30240-8697
US

IV. Provider business mailing address

210 N LEWIS ST
LAGRANGE GA
30240-2738
US

V. Phone/Fax

Practice location:
  • Phone: 706-882-2551
  • Fax:
Mailing address:
  • Phone: 706-882-2551
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code122300000X
TaxonomyDentist
License NumberDN015179
License Number StateGA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: