Provider Demographics
NPI:1528056876
Name:BUFFORD-JONES, RENITA GAIL
Entity type:Individual
Prefix:DR
First Name:RENITA
Middle Name:GAIL
Last Name:BUFFORD-JONES
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:407 W LAFAYETTE ST
Mailing Address - Street 2:
Mailing Address - City:BOLIVAR
Mailing Address - State:TN
Mailing Address - Zip Code:38008-2651
Mailing Address - Country:US
Mailing Address - Phone:731-659-2885
Mailing Address - Fax:731-659-2886
Practice Address - Street 1:407 W LAFAYETTE ST
Practice Address - Street 2:
Practice Address - City:BOLIVAR
Practice Address - State:TN
Practice Address - Zip Code:38008-2651
Practice Address - Country:US
Practice Address - Phone:731-659-2885
Practice Address - Fax:731-659-2886
Is Sole Proprietor?:No
Enumeration Date:2005-10-11
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TN122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist