Provider Demographics
NPI:1205838349
Name:JANNARONE, GARY (DMD)
Entity Type:Individual
Prefix:DR
First Name:GARY
Middle Name:
Last Name:JANNARONE
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 1:435 RINGWOOD AVE
Mailing Address - Street 2:
Mailing Address - City:POMPTON LAKES
Mailing Address - State:NJ
Mailing Address - Zip Code:07442-2208
Mailing Address - Country:US
Mailing Address - Phone:973-835-0702
Mailing Address - Fax:973-835-1383
Practice Address - Street 1:435 RINGWOOD AVE
Practice Address - Street 2:
Practice Address - City:POMPTON LAKES
Practice Address - State:NJ
Practice Address - Zip Code:07442-2208
Practice Address - Country:US
Practice Address - Phone:973-835-0702
Practice Address - Fax:973-835-1383
Is Sole Proprietor?:Not Answered
Enumeration Date:2005-06-01
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ0144481223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice