Organization Name: | KOFFORD, JONES, INGERSOLL & SMITH, DDS PLLC |
NPI Number: | 1467817254 |
Entity Type Code: | Organizational (2) |
Authorized Official Name: | BLAKE RYAN JONES (MEMBER) |
Mailing Address: | 422 N Holly Ave Siler City |
State: | NC US |
Postal Code: | 273443063 |
Phone Number: | 9197422392 |
Fax Number: | |
NPI Enumeration Date: | 12/21/2015 |
NPI Last Update Date: | 12/21/2015 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 261QD0000X |
License Number: | |
Healthcare Provider Taxonomy: (Secondary) | Y |
State: | |
Taxonomy Type: | Ambulatory Health Care Facilities |
Taxonomy Classification: | Clinic/Center |
Taxonomy Specialization: | Dental |
Taxonomy Definition: |