MEDICARE: DR. BRANT CHANDLER JONES D.M.D

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	1223G0001X	General Practice Dentistry	03721	NH

General Provider Information

NPI Number	:	1316031875
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. BRANT CHANDLER JONES D.M.D

Provider Business Mailing Address
First Line	:	PO BOX 7325
Second Line	:
City	:	LACONIA
State	:	NH
Zip	:	03247-7325
Country	:	US
Telephone Number	:	603-524-8250
Fax Number	:

Provider Business Practice Location Address
First Line	:	25 COUNTRY CLUB RD
Second Line	:	VILLAGE WEST ONE BLDG 4
City	:	GILFORD
State	:	NH
Zip	:	03249-6972
Country	:	US
Telephone Number	:	603-524-8250
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	10/02/2006
Last Update Date	:	12/31/2009

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