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Individual
DR. KELLY M JONES
Active
Individual
DR. KELLY M JONES
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
D.M.D.
Taxonomy
Speciality
Code
Description
License number
State
1223P0221X
Pediatric Dentistry
Primary
5534
AL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
100200
AVESIS MEDICAID
GA
05
—
102176
—
AL
05
—
812080119A
—
GA
01
—
9181143
DORAL MEDICAID
GA
Enumeration date
12/04/2006
Last updated
04/07/2014
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