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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