Individual
LOGAN T JONES
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
DDS
Contact information
Practice address
1300 SLACK ST, PEA RIDGE, AR 72751-3914
(479) 488-6131
(479) 488-6215
Mailing address
1300 SLACK ST, PEA RIDGE, AR 72751-3914
(479) 488-6131
(479) 488-3215
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
2018017539
MO
1223G0001X
General Practice Dentistry
Primary
4276
AR
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
2018017539
MO LICENSE
MO
01
—
4276
AR LICENSE
AR
Enumeration date
05/29/2018
Last updated
03/13/2023
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