MEDICARE: ERIC W. JONES, DMD, PC

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	DN014285	GA

General Provider Information

NPI Number	:	1396023859
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	ERIC W. JONES, DMD, PC

Provider Business Mailing Address
First Line	:	7338 SPOUT SPRINGS RD
Second Line	:	SUITE C-15
City	:	FLOWERY BRANCH
State	:	GA
Zip	:	30542-5803
Country	:	US
Telephone Number	:	770-680-1435
Fax Number	:

Provider Business Practice Location Address
First Line	:	7338 SPOUT SPRINGS RD
Second Line	:	SUITE C-15
City	:	FLOWERY BRANCH
State	:	GA
Zip	:	30542-5803
Country	:	US
Telephone Number	:	770-680-1435
Fax Number	:

Authorized Official
Title or Position	:	OWNER
Name	:	ERIC W JONES
Credential	:	DMD
Telephone Number	:	770-680-1435

Provider Enumeration Date	:	08/01/2011
Last Update Date	:	08/01/2011

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