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General NPI Number Information
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NPI Number | 1063554640
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Entity Type | Organization
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Legal Business Name | JEFFERY B JONES A PROFESSIONAL CORPORATION
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Dates
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Enumeration Date | 02/12/2007
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Last Update Date | 08/22/2020
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Provider Practice Location Address
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Address Line | 2977 WOODSIDE ROAD
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City | WOODSIDE
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State | CA
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Zip | 94062
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Country | US
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Telephone | 650-851-0831
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Fax | 650-851-0871
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Provider Business Mailing Address
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Address Line | 2977 WOODSIDE ROAD
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City | WOODSIDE
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State | CA
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Zip | 94062
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Country | US
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Telephone | 650-851-0831
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Fax | 650-851-0871
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Authorized Official
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Title or Position | OWNER
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Name | JEFFERY B JONES
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Credential | DDS
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Telephone | 650-851-0831
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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 | 36773
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License Number State | CA
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