MEDICARE: JOHN S AVANT, DDS, PC

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	1223G0001X	General Practice Dentistry	7013	GA

General Provider Information

NPI Number	:	1366515090
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	JOHN S AVANT, DDS, PC

Provider Business Mailing Address
First Line	:	2050 WARM SPRINGS RD
Second Line	:
City	:	COLUMBUS
State	:	GA
Zip	:	31904-7932
Country	:	US
Telephone Number	:	706-327-4513
Fax Number	:	706-327-6917

Provider Business Practice Location Address
First Line	:	2050 WARM SPRINGS RD
Second Line	:
City	:	COLUMBUS
State	:	GA
Zip	:	31904-7932
Country	:	US
Telephone Number	:	706-327-4513
Fax Number	:	706-327-6917

Authorized Official
Title or Position	:	PRESIDENT
Name	:	JOHN S AVANT
Credential	:	DDS
Telephone Number	:	706-327-4513

Provider Enumeration Date	:	11/17/2006
Last Update Date	:	08/22/2020

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