Provider Demographics
NPI:1568575934
Name:GAVELIS, JONAS RIMVYDAS (DMD)
Entity Type:Individual
Prefix:DR
First Name:JONAS
Middle Name:RIMVYDAS
Last Name:GAVELIS
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 1:227 MAIN ST
Mailing Address - Street 2:
Mailing Address - City:ROCKPORT
Mailing Address - State:MA
Mailing Address - Zip Code:01966-2024
Mailing Address - Country:US
Mailing Address - Phone:978-546-3020
Mailing Address - Fax:978-546-6162
Practice Address - Street 1:227 MAIN ST
Practice Address - Street 2:
Practice Address - City:ROCKPORT
Practice Address - State:MA
Practice Address - Zip Code:01966-2024
Practice Address - Country:US
Practice Address - Phone:978-546-3020
Practice Address - Fax:978-546-6162
Is Sole Proprietor?:Yes
Enumeration Date:2006-08-17
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MA13137122300000X, 1223P0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Not Answered122300000XDental ProvidersDentist
Not Answered1223P0700XDental ProvidersDentistProsthodontics