# GATEWAY FAMILY DENTISTRY SEDATION AND IMPLANT PLLC

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- **Entity:** Organization
- **Status:** Active
- **Organization subpart:** No

## Provider details

- **NPI number:** 1871052886
- **Authorized official:** CHRIS ERWIN (BUSINESS MANAGER)
- **Authorized official phone:** (615) 962-8505

## Contact information

- **Practice address:** 413 N THOMPSON LN, MURFREESBORO, TN 37129-4311
- **Practice address phone:** (615) 962-8505
- **Mailing address:** 413 N THOMPSON LN, MURFREESBORO, TN 37129-4311
- **Mailing address phone:** (615) 962-8505

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 1223G0001X | General Practice Dentistry | — | NULL | Yes |
| 1223G0001X | General Practice Dentistry | — | — | Yes |

## Other

- **Enumeration date:** 03/19/2019
- **Last updated:** 11/15/2021

## Other identifiers

| Code | Description | Identifier | Issuer | State |
| --- | --- | --- | --- | --- |
| 01 | — | 10359 | TBOD | TN |