NPI | 1083848568 |
---|---|
Doing Business As | GATEWAY DENTAL GROUP AND ORTHODONTICS |
Entity Type | Organization |
Authorized Contact | CLINTON H PARK Owner Doctor 760-431-8112 |
Organization Subpart ? | No |
Primary Taxonomy | 1223G0001X Dentist, General Practice |
Enumeration Date | 2009-05-12 |
Last Update Date | 2013-08-19 |