Individual
ANTHONY PAVENTY
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
D.M.D., M.S.
Contact information
Practice address
2434 NW PROFESSIONAL DR, CORVALLIS, OR 97330-3991
(541) 758-3104
Mailing address
2434 NW PROFESSIONAL DR, CORVALLIS, OR 97330-3991
(541) 758-3104
Taxonomy
Speciality
Code
Description
License number
State
1223X0400X
Orthodontics and Dentofacial Orthopedics Dentistry
Primary
D9209
OR
Other
Enumeration date
12/08/2008
Last updated
12/08/2008
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