Organization
BYRON DUVALL D.D.S. GATEWAY, P.C.
Active
Organization subpart
No
Provider details
NPI number
Authorized official
BYRON DUVALL D.D.S. (OWNER)
(800) 409-2563
Entity
Organization
Contact information
Practice address
9378 OLIVE BLVD, SUITE 1LL, OLIVETTE, MO 63132-3215
(800) 409-2563
Mailing address
1904 W. PARKSIDE LANE, SUITE 201, PHOENIX, AZ 85027
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
013419
MO
Other
Enumeration date
11/11/2010
Last updated
11/11/2010
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