NPI | 1851476766 |
---|---|
Doing Business As | GATEWAY PLAZA DENTAL CLINIC |
Entity Type | Organization |
Authorized Contact | JAIME VICTORES EVANGELISTA Dentist 510-887-6835 |
Organization Subpart ? | No |
Primary Taxonomy | 1223G0001X Dentist, General Practice (Licence: CA 37103) |
Enumeration Date | 2006-10-26 |
Last Update Date | 2020-08-22 |