| NPI | 1700534898 |
|---|---|
| Doing Business As | GATEWAY DENTAL PRACTICE |
| Entity Type | Organization |
| Authorized Contact | JACOB ALAN WOOD Owner, CEO 805-540-9309 |
| Organization Subpart ? | No |
| Primary Taxonomy | 122300000X Dentist |
| Additional Taxonomies | 261QD0000X Clinic/Center, Dental |
| Enumeration Date | 2022-03-17 |
| Last Update Date | 2022-03-20 |