Organization
GATEWAY DENTAL
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. PABLO MIRANDA DMD (OWNER)
(305) 325-0050
Entity
Organization
Contact information
Practice address
1050 NW 14TH ST # 204, MIAMI, FL 33136-2105
(305) 856-2300
(305) 856-0921
Mailing address
1050 NW 14TH ST # 204, MIAMI, FL 33136-2105
(305) 856-2300
(305) 856-0921
Taxonomy
Speciality
Code
Description
License number
State
122300000X
Dentist
Primary
DN15212
FL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
101365200
—
FL
Enumeration date
07/17/2013
Last updated
07/19/2019
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