Provider Demographics
NPI:1770601726
Name:JONES, ROBERT NATHAN (DDS)
Entity type:Individual
Prefix:DR
First Name:ROBERT
Middle Name:NATHAN
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 1:10 S 300 E
Mailing Address - Street 2:
Mailing Address - City:PROVO
Mailing Address - State:UT
Mailing Address - Zip Code:84606-3201
Mailing Address - Country:US
Mailing Address - Phone:801-375-8770
Mailing Address - Fax:801-375-0397
Practice Address - Street 1:10 S 300 E
Practice Address - Street 2:
Practice Address - City:PROVO
Practice Address - State:UT
Practice Address - Zip Code:84606-3201
Practice Address - Country:US
Practice Address - Phone:801-375-8770
Practice Address - Fax:801-375-0397
Is Sole Proprietor?:Yes
Enumeration Date:2007-03-27
Last Update Date:2018-01-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
UT493530099221223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice