| Gateway Dental Group, Llc | |
|
606 Edwardsville Road Troy IL 62294 | |
| (618) 667-8020 | |
| (618) 667-8078 |
| Full Name | Gateway Dental Group, Llc |
|---|---|
| Speciality | Dentist - General Practice |
| Location | 606 Edwardsville Road, Troy, Illinois |
| Authorized Official Name and Position | Richard R Boatman (MANAGER) |
| Authorized Official Contact | 6186678070 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Gateway Dental Group, Llc 606 Edwardsville Road Troy IL 62294 Ph: (618) 667-8020 | Gateway Dental Group, Llc 606 Edwardsville Road Troy IL 62294 Ph: (618) 667-8020 |
| NPI Number | 1437601283 |
|---|---|
| Provider Enumeration Date | 10/27/2016 |
| Last Update Date | 10/27/2016 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1437601283 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 1223G0001X | Dentist - General Practice | 19-025636 (Illinois) | Secondary |
| 1223G0001X | Dentist - General Practice | 19-020938 (Illinois) | Primary |
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A To Z Family Dentistry, Pc Dental Clinic Medicare: Not Enrolled in Medicare Practice Location: 120 W Market St, Troy, IL 62294 Phone: 618-667-6453 Fax: 618-667-6173 | |
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Kurt D James Dds Pc Dental Clinic Medicare: Not Enrolled in Medicare Practice Location: 550 Edwardsville Rd, Troy, IL 62294 Phone: 618-667-3446 Fax: 618-667-4141 | |
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