Organization
GATEWAY DENTAL LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. CELESTE C MORTENSON (PRESIDENT)
(435) 752-0605
Entity
Organization
Contact information
Practice address
202 N GATEWAY DR, PROVIDENCE, UT 84332-9001
(435) 752-0605
(435) 755-8574
Mailing address
202 N GATEWAY DR, PROVIDENCE, UT 84332-9001
(435) 512-0133
(435) 755-8574
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
—
—
Other
Enumeration date
06/06/2018
Last updated
04/13/2026
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