Individual
MICHAEL JONES
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
101 ELM AVE SE, ROANOKE, VA 24013-2222
(540) 224-4380
Mailing address
6957 OLD MILL RD, ROANOKE, VA 24018-6710
Taxonomy
Speciality
Code
Description
License number
State
1223P0221X
Pediatric Dentistry
Primary
0401-007411
VA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
8200629
—
VA
Enumeration date
04/10/2006
Last updated
11/09/2008
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