| NPI | 1508091687 |
|---|---|
| Doing Business As | COLUMBIA GATEWAY DENTISTRY |
| Entity Type | Organization |
| Authorized Contact | SHADI GHOZATI Dentis/ Owner 410-872-0104 |
| Organization Subpart ? | No |
| Primary Taxonomy | 122300000X Dentist (Licence: MD 13298) |
| Enumeration Date | 2009-05-19 |
| Last Update Date | 2009-05-19 |