| Gateway Dental Inc | |
|
11880 Sw 40th St Suite 215 Miami FL 33175-3584 | |
| (305) 552-1553 | |
| (305) 325-0935 |
| Full Name | Gateway Dental Inc |
|---|---|
| Speciality | Dentist |
| Location | 11880 Sw 40th St, Miami, Florida |
| Authorized Official Name and Position | Pablo Miranda (OWNER) |
| Authorized Official Contact | 3055521553 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Gateway Dental Inc 11880 Sw 40th St Suite 215 Miami FL 33175-3584 Ph: (305) 552-1553 | Gateway Dental Inc 11880 Sw 40th St Suite 215 Miami FL 33175-3584 Ph: (305) 552-1553 |
| NPI Number | 1760868863 |
|---|---|
| Provider Enumeration Date | 07/31/2015 |
| Last Update Date | 07/23/2019 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1760868863 | NPI | - | NPPES |
| 101379200 | Medicaid | FL |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 122300000X | Dentist | DN15212 (Florida) | Primary |
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