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General NPI Number Information
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NPI Number | 1972254951
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Entity Type | Organization
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Legal Business Name | DR CARLOS M JONES FAMILY DENTAL CENTER PC
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Dates
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Enumeration Date | 01/12/2022
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Last Update Date | 01/12/2022
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Provider Practice Location Address
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Address Line | 14807 W MCNICHOLS RD
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City | DETROIT
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State | MI
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Zip | 48235-3939
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Country | US
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Telephone | 313-493-0110
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Fax | 313-493-1121
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Provider Business Mailing Address
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Address Line | 14807 W MCNICHOLS RD
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City | DETROIT
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State | MI
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Zip | 48235-3939
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Country | US
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Telephone | 313-493-0110
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Fax | 313-493-1121
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Authorized Official
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Title or Position | OFFICE MANAGER
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Name | ANGELO JONES
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Credential |
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Telephone | 313-530-8737
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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 |
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License Number State |
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