NPI | 1548303555 |
---|---|
Doing Business As | GATEWAY DENTAL CARE |
Entity Type | Organization |
Authorized Contact | JOHN B CODJOE Owner 508-771-7751 |
Organization Subpart ? | No |
Primary Taxonomy | 302F00000X Exclusive Provider Organization (Licence: MA DN1855757) |
Enumeration Date | 2007-02-15 |
Last Update Date | 2011-10-07 |