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General NPI Number Information
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NPI Number | 1437616349
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Entity Type | Organization
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Legal Business Name | DAGON JONES DDS INC.
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Dates
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Enumeration Date | 02/27/2019
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Last Update Date | 02/27/2019
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Provider Practice Location Address
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Address Line | 2800 5TH STREET SUITE 100
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City | DAVIS
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State | CA
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Zip | 95618
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Country | US
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Telephone | 530-756-5300
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Fax | 530-756-4941
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Provider Business Mailing Address
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Address Line | 2800 5TH STREET SUITE 100
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City | DAVIS
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State | CA
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Zip | 95618
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Country | US
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Telephone | 530-756-5300
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Fax | 530-756-4941
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Authorized Official
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Title or Position | OWNER
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Name | DAGON HURRICANE CASEY JONES
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Credential | DDS
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Telephone | 530-756-5300
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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 |
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License Number State |
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