Provider Demographics
NPI:1508289448
Name:ARUNA AVANTI DDS.,PA.
Entity Type:Organization
Organization Name:ARUNA AVANTI DDS.,PA.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:DIRECTOR
Authorized Official - Prefix:DR
Authorized Official - First Name:ARUNA
Authorized Official - Middle Name:
Authorized Official - Last Name:AVANTI
Authorized Official - Suffix:
Authorized Official - Credentials:DDS
Authorized Official - Phone:904-683-1065
Mailing Address - Street 1:9191 R G SKINNER PKWY
Mailing Address - Street 2:SUITE 301
Mailing Address - City:JACKSONVILLE
Mailing Address - State:FL
Mailing Address - Zip Code:32256-9655
Mailing Address - Country:US
Mailing Address - Phone:904-683-1065
Mailing Address - Fax:904-683-1067
Practice Address - Street 1:9191 R G SKINNER PKWY
Practice Address - Street 2:SUITE 301
Practice Address - City:JACKSONVILLE
Practice Address - State:FL
Practice Address - Zip Code:32256-9655
Practice Address - Country:US
Practice Address - Phone:904-683-1065
Practice Address - Fax:904-683-1067
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2014-01-29
Last Update Date:2014-01-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLDN17406122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes122300000XDental ProvidersDentistGroup - Multi-Specialty