NPI | 1215396809 |
---|---|
Doing Business As | GATEWAY PLAZA DENTAL |
Entity Type | Organization |
Authorized Contact | JAIME V EVANGELISTA Dentist 510-887-6835 |
Organization Subpart ? | No |
Primary Taxonomy | 122300000X Dentist (Licence: CA 37103) |
Enumeration Date | 2016-02-11 |
Last Update Date | 2016-02-11 |