Provider Demographics
NPI:1003929290
Name:GAILIUNAS, ERNEST ALGIS (DMD)
Entity Type:Individual
Prefix:
First Name:ERNEST
Middle Name:ALGIS
Last Name:GAILIUNAS
Suffix:
Gender:M
Credentials:DMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:10 MAIN STREET
Mailing Address - Street 2:
Mailing Address - City:COTUIT
Mailing Address - State:MA
Mailing Address - Zip Code:02635
Mailing Address - Country:US
Mailing Address - Phone:508-428-3392
Mailing Address - Fax:508-428-5348
Practice Address - Street 1:10 MAIN STREET
Practice Address - Street 2:AESTHETIC DENTAL CARE
Practice Address - City:COTUIT
Practice Address - State:MA
Practice Address - Zip Code:02635
Practice Address - Country:US
Practice Address - Phone:508-428-3392
Practice Address - Fax:508-428-5348
Is Sole Proprietor?:Yes
Enumeration Date:2006-08-15
Last Update Date:2014-05-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MA149501223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice