| 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 |