Individual
RANDALL C JONES
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
DMD
Contact information
Practice address
1004 MONMOUTH ST, INDEPENDENCE, OR 97351-1323
(503) 838-0434
(503) 838-4751
Mailing address
14896 FERNS CORNER RD, MONMOUTH, OR 97361-9656
(503) 623-9473
(503) 838-4751
Taxonomy
Speciality
Code
Description
License number
State
122300000X
Dentist
Primary
D8005
OR
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
71 0969871
GENERAL DENTISTY
OR
Enumeration date
03/23/2007
Last updated
04/30/2021
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