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General NPI Number Information
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NPI Number | 1013163609
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Entity Type | Organization
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Legal Business Name | DURST & JONES FAMILY DENTAL, LLP
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Dates
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Enumeration Date | 08/14/2008
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Last Update Date | 08/14/2008
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Provider Practice Location Address
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Address Line | 2325 WASHINGTON RD
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City | AUGUSTA
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State | GA
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Zip | 30904-3105
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Country | US
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Telephone | 706-736-7146
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Fax | 706-736-9938
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Provider Business Mailing Address
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Address Line | 2325 WASHINGTON RD
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City | AUGUSTA
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State | GA
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Zip | 30904-3105
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Country | US
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Telephone | 706-736-7146
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Fax | 706-736-9938
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Authorized Official
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Title or Position | DENTIST/OWNER
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Name | DR. SUSAN K JONES
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Credential | DMD
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Telephone | 706-736-7146
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 122300000X
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Taxonomy Name | Dentist
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License Number | DN013339
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License Number State | GA
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