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Organization
GAUNT FAMILY AND COSMETIC DENTISTRY
Active
Organization
GAUNT FAMILY AND COSMETIC DENTISTRY
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. JAY ROBERT GAUNT DDS (OWNER)
(570) 753-5403
Entity
Organization
Contact information
Practice address
107 E CENTRAL AVE, AVIS, PA 17721-8904
(570) 753-5403
(570) 753-5485
Mailing address
107 E CENTRAL AVE, PO BOX 710, AVIS, PA 17721-8904
(570) 753-5403
(570) 753-5485
Taxonomy
Speciality
Code
Description
License number
State
261QD0000X
Dental Clinic/Center
Primary
DS-022420-L
PA
Other
Enumeration date
09/18/2008
Last updated
09/18/2008
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