Individual
ROBERT SCOTT GATEWOOD
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
D.M.D.
Contact information
Practice address
2500 N STATE ST, JACKSON, MS 39216-4500
(601) 984-6155
(601) 815-3901
Mailing address
2500 N STATE ST, JACKSON, MS 39216-4500
(601) 984-6155
(601) 815-3901
Taxonomy
Speciality
Code
Description
License number
State
122300000X
Dentist
Primary
2075-84
MS
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
00660325
—
MS
Enumeration date
02/22/2007
Last updated
07/09/2007
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