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General NPI Number Information
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NPI Number | 1457408874
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Entity Type | Individual
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Provider Name | DEBORAH S. JONES D.D.S.
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Gender | Female
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Dates
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Enumeration Date | 01/05/2007
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Last Update Date | 02/07/2015
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Provider Practice Location Address
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Address Line | 650 W BALTIMORE ST
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City | BALTIMORE
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State | MD
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Zip | 21201-1510
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Country | US
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Telephone | 410-706-7201
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Fax |
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Provider Business Mailing Address
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Address Line | 5716 KENMORE RD
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City | BALTIMORE
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State | MD
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Zip | 21210-1321
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Country | US
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Telephone | 301-639-0961
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 1223P0300X
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Taxonomy Name | Periodontics
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License Number | 11254
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License Number State | MD
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