MEDICARE: DANIEL P.R. JONES DDS

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	DEN1000360	DC

General Provider Information

NPI Number	:	1548464829
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DANIEL P.R. JONES DDS

Provider Business Mailing Address
First Line	:	631 4TH ST SW
Second Line	:
City	:	WASHINGTON
State	:	DC
Zip	:	20024-2717
Country	:	US
Telephone Number	:	202-554-5011
Fax Number	:	202-756-0023

Provider Business Practice Location Address
First Line	:	631 4TH ST SW
Second Line	:
City	:	WASHINGTON
State	:	DC
Zip	:	20024-2717
Country	:	US
Telephone Number	:	202-554-5011
Fax Number	:	202-756-0023

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

Provider Enumeration Date	:	06/12/2007
Last Update Date	:	07/08/2007

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