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General NPI Number Information
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NPI Number | 1851846364
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Entity Type | Organization
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Legal Business Name | M. THOMAS JONES
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Dates
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Enumeration Date | 08/25/2016
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Last Update Date | 10/04/2024
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Provider Practice Location Address
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Address Line | 5710 W GATE CITY BLVD STE R
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City | GREENSBORO
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State | NC
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Zip | 27407-7047
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Country | US
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Telephone | 336-294-0722
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Fax | 336-294-0735
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Provider Business Mailing Address
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Address Line | 5613 DURALEIGH RD SUITE 131
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City | RALEIGH
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State | NC
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Zip | 27612-2694
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Country | US
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Telephone | 919-835-1998
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Fax | 191-719-0389
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Authorized Official
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Title or Position | PRACTICE MANAGER
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Name | MARIA I HENDERSON
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Credential |
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Telephone | 336-294-0722
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 1223G0001X
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Taxonomy Name | General Practice Dentistry
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License Number | 6444
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License Number State | NC
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