| Gateway Oral Surgery | |
|
180 Capulet Dr Ste 3 Saint Augustine FL 32092-4541 | |
| (904) 299-2942 | |
| (904) 299-2943 |
| Full Name | Gateway Oral Surgery |
|---|---|
| Speciality | Clinic/center - Dental |
| Location | 180 Capulet Dr Ste 3, Saint Augustine, Florida |
| Authorized Official Name and Position | Roger Myers (OWNER) |
| Authorized Official Contact | 9042004375 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Gateway Oral Surgery 180 Capulet Dr Ste 3 Saint Augustine FL 32092-4541 Ph: (904) 299-2942 | Gateway Oral Surgery 180 Capulet Dr Ste 3 Saint Augustine FL 32092-4541 Ph: (904) 299-2942 |
| NPI Number | 1073336483 |
|---|---|
| Provider Enumeration Date | 11/04/2024 |
| Last Update Date | 11/04/2024 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1073336483 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261QD0000X | Clinic/center - Dental | (* (Not Available)) | Primary |
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