| Gateway Dental | |
|
1050 Nw 14th St # 204 Miami FL 33136-2105 | |
| (305) 856-2300 | |
| (305) 856-0921 |
| Full Name | Gateway Dental |
|---|---|
| Speciality | Dentist |
| Location | 1050 Nw 14th St # 204, Miami, Florida |
| Authorized Official Name and Position | Pablo Miranda (OWNER) |
| Authorized Official Contact | 3053250050 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Gateway Dental 1050 Nw 14th St # 204 Miami FL 33136-2105 Ph: (305) 856-2300 | Gateway Dental 1050 Nw 14th St # 204 Miami FL 33136-2105 Ph: (305) 856-2300 |
| NPI Number | 1861834905 |
|---|---|
| Provider Enumeration Date | 07/17/2013 |
| Last Update Date | 07/19/2019 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1861834905 | NPI | - | NPPES |
| 101365200 | Medicaid | FL |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 122300000X | Dentist | DN15212 (Florida) | Primary |
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