Healthcare Provider Details

I. General information

NPI: 1366610859
Provider Name (Legal Business Name): AIKEN, MUNSON, & JONES, I, PA
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 02/19/2008
Last Update Date: 11/26/2019
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

688 SUNSET BLVD N.
SUNSET BEACH NC
28468
US

IV. Provider business mailing address

1611 NW 12 AVENUE UROLOGY DEPARTMENT
MIAMI FL
33136
US

V. Phone/Fax

Practice location:
  • Phone: 910-575-6300
  • Fax: 910-575-6311
Mailing address:
  • Phone: 305-243-3670
  • Fax: 305-243-4653

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code122300000X
TaxonomyDentist
License Number7618
License Number StateNC

VIII. Authorized Official

Name: GEORGE S JONES I III
Title or Position: OWNER
Credential: DMD
Phone: 910-575-6300