| Gateway General Dentistry | |
|
112 Jefferson Ave Suite 002 Columbus OH 43215-1861 | |
| (614) 262-8180 | |
| (614) 262-2883 |
| Full Name | Gateway General Dentistry |
|---|---|
| Speciality | Dentist |
| Location | 112 Jefferson Ave, Columbus, Ohio |
| Authorized Official Name and Position | Robert W. Gardner (OWNER) |
| Authorized Official Contact | 6142628180 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Gateway General Dentistry 112 Jefferson Ave Suite 002 Columbus OH 43215-1861 Ph: (614) 262-8180 | Gateway General Dentistry 112 Jefferson Ave Suite 002 Columbus OH 43215-1861 Ph: (614) 262-8180 |
| NPI Number | 1659684983 |
|---|---|
| Provider Enumeration Date | 07/15/2010 |
| Last Update Date | 07/15/2010 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1659684983 | NPI | - | NPPES |
| 0978483 | Medicaid | OH |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 122300000X | Dentist | 30020068 (Ohio) | Primary |
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