Provider Demographics
NPI:1740314939
Name:GAWLIK, JOHN ANTON JR (DDS)
Entity type:Individual
Prefix:DR
First Name:JOHN
Middle Name:ANTON
Last Name:GAWLIK
Suffix:JR
Gender:M
Credentials:DDS
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Mailing Address - Street 1:8100 PENN AVE SOUTH
Mailing Address - Street 2:SUITE 172
Mailing Address - City:BLOOMINGTON
Mailing Address - State:MN
Mailing Address - Zip Code:55431-1325
Mailing Address - Country:US
Mailing Address - Phone:952-884-8337
Mailing Address - Fax:952-884-8166
Practice Address - Street 1:8100 PENN AVE SOUTH
Practice Address - Street 2:SUITE 172
Practice Address - City:BLOOMINGTON
Practice Address - State:MN
Practice Address - Zip Code:55431-1325
Practice Address - Country:US
Practice Address - Phone:952-884-8337
Practice Address - Fax:952-884-8166
Is Sole Proprietor?:No
Enumeration Date:2007-03-16
Last Update Date:2007-07-08
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Provider Licenses
StateLicense IDTaxonomies
MN81751223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice