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Organization
ILIEN JIMENIZ MINTER DDS INC
Active
Organization
ILIEN JIMENIZ MINTER DDS INC
Active
Other names
Gateway Dental Gateway Dentistry
Organization subpart
No
Provider details
NPI number
Authorized official
DR. ILIEN J MINTER DDS (OWNER)
(858) 485-8420
Entity
Organization
Contact information
Practice address
15725 POMERADO RD, STE 204, POWAY, CA 92064
(858) 485-8420
(858) 485-5773
Mailing address
15725 POMERADO RD, STE 204, POWAY, CA 92064
(858) 485-8420
(858) 485-5773
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
38912
CA
1223G0001X
General Practice Dentistry
51974
CA
1223G0001X
General Practice Dentistry
55919
CA
1223G0001X
General Practice Dentistry
Primary
DUO34933
CA
Other
Enumeration date
11/27/2006
Last updated
04/20/2008
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