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General NPI Number Information
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NPI Number | 1225687692
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Entity Type | Individual
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Provider Name | JULIANNE FANNY AVRUTIK DDS
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Gender | Female
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Dates
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Enumeration Date | 09/09/2019
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Last Update Date | 12/17/2019
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Provider Practice Location Address
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Address Line | 395 RIDGE RD STE 5
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City | DAYTON
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State | NJ
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Zip | 08810-1398
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Country | US
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Telephone | 732-274-2544
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Fax |
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Provider Business Mailing Address
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Address Line | 22 ELEANOR DR
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City | KENDALL PARK
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State | NJ
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Zip | 08824-1816
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Country | US
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Telephone | 908-812-5633
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 1223G0001X
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Taxonomy Name | General Practice Dentistry
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License Number | 22DI02733100
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License Number State | NJ
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