Organization
GATEWAY FAMILY DENTISTRY SEDATION AND IMPLANT PLLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
CHRIS ERWIN (BUSINESS MANAGER)
(615) 962-8505
Entity
Organization
Contact information
Practice address
413 N THOMPSON LN, MURFREESBORO, TN 37129-4311
(615) 962-8505
Mailing address
413 N THOMPSON LN, MURFREESBORO, TN 37129-4311
(615) 962-8505
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
10359
TBOD
TN
Enumeration date
03/19/2019
Last updated
11/15/2021
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