Provider Demographics
NPI:1588927941
Name:JONES, DAVID KEITH (DDS)
Entity type:Individual
Prefix:
First Name:DAVID
Middle Name:KEITH
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 1:1301 RIDGWAY RD STE 2B
Mailing Address - Street 2:
Mailing Address - City:PINE BLUFF
Mailing Address - State:AR
Mailing Address - Zip Code:71603-7608
Mailing Address - Country:US
Mailing Address - Phone:901-359-6251
Mailing Address - Fax:
Practice Address - Street 1:1301 RIDGWAY RD STE 2B
Practice Address - Street 2:
Practice Address - City:PINE BLUFF
Practice Address - State:AR
Practice Address - Zip Code:71603-7608
Practice Address - Country:US
Practice Address - Phone:870-535-8600
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2012-06-20
Last Update Date:2016-09-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AR3877122300000X, 1223P0221X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223P0221XDental ProvidersDentistPediatric Dentistry
No122300000XDental ProvidersDentist