Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 1223P0700X | Prosthodontist | DN 20089 | FL |
NPI | 1053745364 |
---|---|
Provider Name | Dr. Adam Robert Jones |
First Address | Vero Beach, FL 32963-4000 |
Second Address | Vero Beach, FL 32963 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 23/08/2013 |
Last Update Date | 06/11/2014 |