Organization
GATEWAY DENTAL CLINIC, PC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. JOSEF SEDIVY DDS (PRESIDENT)
(503) 252-0048
Entity
Organization
Contact information
Practice address
10305 NE HALSEY ST, PORTLAND, OR 97220-3954
(503) 252-0048
(503) 256-4041
Mailing address
10305 NE HALSEY ST, PORTLAND, OR 97220-3954
(503) 252-0048
(503) 256-4041
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
D7355
OR
Other
Enumeration date
01/28/2011
Last updated
01/28/2011
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