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Organization
GATEWAY DENTAL SURGERY CENTER
Active
Organization
GATEWAY DENTAL SURGERY CENTER
Active
Parent organization
DENTAL SERVICE, LLC
Organization subpart
Yes
Provider details
NPI number
Legal business name
DENTAL SERVICE, LLC
Authorized official
KEVIN BOIE (CFO)
(360) 571-8181
Entity
Organization
Contact information
Practice address
10535 NE GLISAN ST STE 101, PORTLAND, OR 97220-4095
(971) 229-8777
Mailing address
10535 NE GLISAN ST STE 101, PORTLAND, OR 97220-4095
(971) 229-8777
Taxonomy
Speciality
Code
Description
License number
State
261QA1903X
Ambulatory Surgical Clinic/Center
Primary
—
NULL
Other
Enumeration date
06/10/2015
Last updated
06/10/2015
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