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Individual

DR. KELLY M JONES

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
F
Credential
D.M.D.

Contact information

Practice address
9807 MCSARA CT., SPANISH FORT, AL 36527
(251) 626-9924
Mailing address
9807 MCSARA CT., SPANISH FORT, AL 36527
(251) 626-9924
(251) 626-9984

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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