Individual
DR. JUSTIN L JONES
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
DDS
Contact information
Practice address
150 NE KENNETH FORD DR, ROSEBURG, OR 97470-1042
(541) 672-9596
Mailing address
150 NE KENNETH FORD DR, ROSEBURG, OR 97470-1042
(541) 672-9596
Taxonomy
Speciality
Code
Description
License number
State
122300000X
Dentist
26305
TX
122300000X
Dentist
5901
OK
1223D0001X
Public Health Dentistry
Primary
D11436
OR
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
200089560A
—
OK
Enumeration date
11/28/2006
Last updated
05/10/2022
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