Individual
DR. RANDALL STEPHON JONES
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
DMD
Contact information
Practice address
3053B FREEDOM DR, CHARLOTTE, NC 28208-3859
(704) 393-3911
(704) 393-3911
Mailing address
3053B FREEDOM DR, CHARLOTTE, NC 28208-3859
(704) 393-3911
(704) 393-3911
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
3574
SC
1223G0001X
General Practice Dentistry
Primary
8317
NC
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
5905629
—
NC
01
—
903AC
BLUE CROSS BLUE SHIELD NC
—
Enumeration date
03/07/2006
Last updated
05/17/2013
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