Organization
FOURTH STREET FAMILY DENTAL, PC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MR. GREGORY B JONES DMD (OWNER)
(541) 567-1693
Entity
Organization
Contact information
Practice address
530 SE 4TH ST, HERMISTON, OR 97838-2416
(541) 567-1693
(541) 567-2840
Mailing address
530 SE 4TH STREET, HERMISTON, OR 97838
(541) 567-1693
(541) 567-2840
Taxonomy
Speciality
Code
Description
License number
State
122300000X
Dentist
Primary
D6986
OR
Other
Enumeration date
01/15/2014
Last updated
01/15/2014
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