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General NPI Number Information
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NPI Number | 1073041133
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Entity Type | Organization
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Legal Business Name | MICHAEL H. JONES DMD LLC
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Dates
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Enumeration Date | 06/01/2017
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Last Update Date | 07/21/2022
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Provider Practice Location Address
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Address Line | 701 E HIGH ST
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City | JEFFERSON CITY
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State | MO
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Zip | 65101-4030
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Country | US
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Telephone | 573-636-7432
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Fax |
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Provider Business Mailing Address
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Address Line | 701 E HIGH ST
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City | JEFFERSON CITY
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State | MO
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Zip | 65101-4030
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Country | US
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Telephone | 573-636-7432
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Fax |
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Authorized Official
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Title or Position | DENTIST
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Name | DR. MICHAEL HAROLD JONES
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Credential | DMD
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Telephone | 573-636-7432
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261QD0000X
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Taxonomy Name | Dental Clinic/Center
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License Number | 2017016803
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License Number State | MO
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