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1902287469
GATEWAY DENTAL SURGERY CENTER
PORTLAND, OR
NPI
1902287469
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Entity Type
Organization
Authorized Contact
KEVIN BOIE
CFO
360-571-8181
Organization Subpart ?
Yes
Primary Taxonomy
261QA1903X Clinic/Center, Ambulatory Surgical
Enumeration Date
2015-06-10
Last Update Date
2015-06-10
Business Address
GATEWAY DENTAL SURGERY CENTER
10535 NE GLISAN ST STE 101
PORTLAND, OR 97220-4095
Phone number: 971-229-8777
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Mailing Address
GATEWAY DENTAL SURGERY CENTER
10535 NE GLISAN ST STE 101
PORTLAND, OR 97220-4095
Phone number: 971-229-8777
Copy
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