Individual
JIGNESH BHIKHALAL MODHA
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
DDS
Contact information
Practice address
107 E CENTRAL AVE, AVIS, PA 17721-8904
(570) 753-5403
Mailing address
107 E CENTRAL AVE, AVIS, PA 17721-8904
(570) 753-5403
Taxonomy
Speciality
Code
Description
License number
State
122300000X
Dentist
Primary
DS042416
PA
Other
Enumeration date
08/02/2019
Last updated
02/06/2021
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