Provider Demographics
NPI:1174576516
Name:GAINER, JAMES A (DDS)
Entity type:Individual
Prefix:MR
First Name:JAMES
Middle Name:A
Last Name:GAINER
Suffix:
Gender:M
Credentials:DDS
Other - Prefix:
Other - First Name:
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Mailing Address - Street 1:3725 WRIGHTSVILLE AVE
Mailing Address - Street 2:STE A
Mailing Address - City:WILMINGTON
Mailing Address - State:NC
Mailing Address - Zip Code:28403-4041
Mailing Address - Country:US
Mailing Address - Phone:910-799-9699
Mailing Address - Fax:910-792-9987
Practice Address - Street 1:3725 WRIGHTSVILLE AVE
Practice Address - Street 2:STE A
Practice Address - City:WILMINGTON
Practice Address - State:NC
Practice Address - Zip Code:28403-4041
Practice Address - Country:US
Practice Address - Phone:910-799-9699
Practice Address - Fax:910-792-9987
Is Sole Proprietor?:Yes
Enumeration Date:2006-05-18
Last Update Date:2011-05-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MD8564122300000X
NC9067122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist