Healthcare Provider Details

I. General information

NPI: 1871516724
Provider Name (Legal Business Name): BARRY WEBB JONES JR. D.M.D.
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 07/25/2006
Last Update Date: 06/29/2016
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

712 S COIT ST
FLORENCE SC
29501-5113
US

IV. Provider business mailing address

712 S COIT ST
FLORENCE SC
29501-5113
US

V. Phone/Fax

Practice location:
  • Phone: 843-667-4300
  • Fax: 843-667-0709
Mailing address:
  • Phone: 843-667-4300
  • Fax: 843-667-0709

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code332BC3200X
TaxonomyCustomized Equipment (DME)
License Number1941
License Number StateSC
# 2
Primary TaxonomyY
Taxonomy Code1223P0300X
TaxonomyPeriodontics
License Number1941
License Number StateSC

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: