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General NPI Number Information
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NPI Number | 1386044865
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Entity Type | Organization
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Legal Business Name | JONES AND KOFFORD CARY NC PLLC
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Dates
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Enumeration Date | 09/03/2014
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Last Update Date | 09/03/2014
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Provider Practice Location Address
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Address Line | 200 CORNERSTONE DR SUITE 200
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City | CARY
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State | NC
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Zip | 27519-8428
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Country | US
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Telephone | 919-468-4211
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Fax | 919-882-9458
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Provider Business Mailing Address
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Address Line | 200 CORNERSTONE DR SUITE 200
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City | CARY
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State | NC
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Zip | 27519-8428
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Country | US
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Telephone | 919-468-4211
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Fax | 919-882-9458
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Authorized Official
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Title or Position | GENERAL DENTIST
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Name | DR. BLAKE R JONES
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Credential | DMD
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Telephone | 919-468-4211
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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 | 9695
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License Number State | NC
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Taxonomy #2
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Taxonomy Code | 122300000X
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Taxonomy Name | Dentist
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License Number | 9665
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License Number State | NC
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Taxonomy #3
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Taxonomy Code | 1223P0700X
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Taxonomy Name | Prosthodontics
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License Number | 9664
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License Number State | NC
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Taxonomy #4
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Taxonomy Code | 122300000X
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Taxonomy Name | Dentist
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License Number | 9696
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License Number State | NC
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