| NPI | 1407031164 |
|---|---|
| Doing Business As | GAETA DENTAL - CENTER GATE |
| Entity Type | Organization |
| Authorized Contact | AMY KROEGER Ins Coord 217-540-5100 |
| Organization Subpart ? | Yes |
| Primary Taxonomy | 1223G0001X Dentist, General Practice |
| Enumeration Date | 2007-12-31 |
| Last Update Date | 2007-12-31 |