Provider Demographics
NPI:1356348882
Name:GAVIN, RICK T (DDS)
Entity type:Individual
Prefix:DR
First Name:RICK
Middle Name:T
Last Name:GAVIN
Suffix:
Gender:M
Credentials:DDS
Other - Prefix:
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Mailing Address - Street 1:3600 DE SOUZA PL
Mailing Address - Street 2:STE B
Mailing Address - City:BAKERSFIELD
Mailing Address - State:CA
Mailing Address - Zip Code:93309-5110
Mailing Address - Country:US
Mailing Address - Phone:661-831-4533
Mailing Address - Fax:661-831-1920
Practice Address - Street 1:3600 DE SOUZA PL
Practice Address - Street 2:STE B
Practice Address - City:BAKERSFIELD
Practice Address - State:CA
Practice Address - Zip Code:93309-5110
Practice Address - Country:US
Practice Address - Phone:661-831-4533
Practice Address - Fax:661-831-1920
Is Sole Proprietor?:Not Answered
Enumeration Date:2005-06-30
Last Update Date:2007-07-08
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
CA291491223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice