Provider Demographics
NPI:1427272525
Name:JONES, BRUCE G (DDS)
Entity type:Individual
Prefix:DR
First Name:BRUCE
Middle Name:G
Last Name:JONES
Suffix:
Gender:M
Credentials:DDS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3587 HENRY ST
Mailing Address - Street 2:SUITE 100
Mailing Address - City:MUSKEGON
Mailing Address - State:MI
Mailing Address - Zip Code:49441-6732
Mailing Address - Country:US
Mailing Address - Phone:231-780-5158
Mailing Address - Fax:231-780-5159
Practice Address - Street 1:3587 HENRY ST
Practice Address - Street 2:SUITE 100
Practice Address - City:MUSKEGON
Practice Address - State:MI
Practice Address - Zip Code:49441-6732
Practice Address - Country:US
Practice Address - Phone:231-780-5158
Practice Address - Fax:231-780-5159
Is Sole Proprietor?:Yes
Enumeration Date:2007-04-12
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI150431223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice