MEDICARE: ARUNA AVANTI DDS.,PA.

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	122300000X	Dentist	DN17406	FL

General Provider Information

NPI Number	:	1508289448
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	ARUNA AVANTI DDS.,PA.

Provider Business Mailing Address
First Line	:	9191 R G SKINNER PKWY
Second Line	:	SUITE 301
City	:	JACKSONVILLE
State	:	FL
Zip	:	32256-9655
Country	:	US
Telephone Number	:	904-683-1065
Fax Number	:	904-683-1067

Provider Business Practice Location Address
First Line	:	9191 R G SKINNER PKWY
Second Line	:	SUITE 301
City	:	JACKSONVILLE
State	:	FL
Zip	:	32256-9655
Country	:	US
Telephone Number	:	904-683-1065
Fax Number	:	904-683-1067

Authorized Official
Title or Position	:	DIRECTOR
Name	:	DR. ARUNA AVANTI
Credential	:	DDS
Telephone Number	:	904-683-1065

Provider Enumeration Date	:	01/29/2014
Last Update Date	:	01/29/2014

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