Provider Demographics
NPI:1912479429
Name:B. WEBB JONES, JR. DMD
Entity type:Organization
Organization Name:B. WEBB JONES, JR. DMD
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PERIODONTIST
Authorized Official - Prefix:DR
Authorized Official - First Name:BARRY
Authorized Official - Middle Name:WEBB
Authorized Official - Last Name:JONES
Authorized Official - Suffix:JR
Authorized Official - Credentials:DMD
Authorized Official - Phone:843-667-4300
Mailing Address - Street 1:712 S COIT ST
Mailing Address - Street 2:
Mailing Address - City:FLORENCE
Mailing Address - State:SC
Mailing Address - Zip Code:29501-5113
Mailing Address - Country:US
Mailing Address - Phone:843-667-4300
Mailing Address - Fax:843-667-0709
Practice Address - Street 1:712 S COIT ST
Practice Address - Street 2:
Practice Address - City:FLORENCE
Practice Address - State:SC
Practice Address - Zip Code:29501-5113
Practice Address - Country:US
Practice Address - Phone:843-667-4300
Practice Address - Fax:843-667-0709
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2018-12-21
Last Update Date:2018-12-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1223P0300XDental ProvidersDentistPeriodonticsGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
SC1558610444OtherPERIODONTIST