Provider Demographics
NPI:1952714842
Name:GAYNIER ORTHODONTICS PC
Entity Type:Organization
Organization Name:GAYNIER ORTHODONTICS PC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:BRAD
Authorized Official - Middle Name:
Authorized Official - Last Name:GAYNIER
Authorized Official - Suffix:
Authorized Official - Credentials:DDS
Authorized Official - Phone:877-203-9105
Mailing Address - Street 1:4701 COX RX STE 285
Mailing Address - Street 2:C/O CT CORPORATION
Mailing Address - City:GLEN ALLEN
Mailing Address - State:VA
Mailing Address - Zip Code:23060
Mailing Address - Country:US
Mailing Address - Phone:877-203-9105
Mailing Address - Fax:877-203-9105
Practice Address - Street 1:4701 COX RX STE 285
Practice Address - Street 2:C/O CT CORPORATION
Practice Address - City:GLEN ALLEN
Practice Address - State:VA
Practice Address - Zip Code:23060
Practice Address - Country:US
Practice Address - Phone:877-203-9105
Practice Address - Fax:877-203-9105
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2014-06-09
Last Update Date:2014-07-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261Q00000XAmbulatory Health Care FacilitiesClinic/Center