| NPI | 1821443649 |
|---|---|
| Doing Business As | GATEWAY SMILES DENTISTRY |
| Entity Type | Organization |
| Authorized Contact | KENDRA WALKER Credentialing Team Lead 217-540-8312 |
| Organization Subpart ? | Yes |
| Primary Taxonomy | 1223G0001X Dentist, General Practice |
| Enumeration Date | 2016-04-29 |
| Last Update Date | 2016-04-29 |