| Gateway Dental | |
|
7462 Limestone Dr Gainesville VA 20155-4007 | |
| (703) 753-3346 | |
| (703) 753-8836 |
| Full Name | Gateway Dental |
|---|---|
| Speciality | Dentist |
| Location | 7462 Limestone Dr, Gainesville, Virginia |
| Authorized Official Name and Position | Hicham Mekouar (PRESIDENT) |
| Authorized Official Contact | 7037533346 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Gateway Dental 7462 Limestone Dr Gainesville VA 20155-4007 Ph: (703) 753-3346 | Gateway Dental 7462 Limestone Dr Gainesville VA 20155-4007 Ph: (703) 753-3346 |
| NPI Number | 1215143326 |
|---|---|
| Provider Enumeration Date | 05/15/2007 |
| Last Update Date | 04/28/2010 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1215143326 | NPI | - | NPPES |
| 010335621 | Medicaid | VA |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 122300000X | Dentist | 411070 (Virginia) | Primary |
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