Individual
LARRY TED JONES
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
DMD
Contact information
Practice address
100 MEDICAL CENTER DR, SUITE 205, GADSDEN, AL 35903-1134
(256) 492-6363
(256) 492-0047
Mailing address
100 MEDICAL CENTER DR, SUITE 205, GADSDEN, AL 35903-1134
(256) 492-6363
(256) 492-0047
Taxonomy
Speciality
Code
Description
License number
State
1223S0112X
Oral and Maxillofacial Surgery (Dentist)
Primary
2915
AL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
510-93747
BLUE CROSS BLUE SHIELD
AL
Enumeration date
02/22/2007
Last updated
07/08/2007
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