Individual
DR. GAVIN TO
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
DDS
Contact information
Practice address
65 JEFFERSON AVE, ELIZABETH, NJ 07201-2474
(908) 367-7819
Mailing address
345 E 24TH ST, NEW YORK, NY 10010-4020
(212) 998-9800
Taxonomy
Speciality
Code
Description
License number
State
122300000X
Dentist
064811-01
NY
1223P0221X
Pediatric Dentistry
064811-01
NY
1223P0221X
Pediatric Dentistry
14491
CT
1223P0221X
Pediatric Dentistry
Primary
22DI03004300
NJ
Other
Enumeration date
07/05/2023
Last updated
08/14/2025
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