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General NPI Number Information
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NPI Number | 1992834121
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Entity Type | Organization
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Legal Business Name | GATEWAY DENTAL GROUP, LLP
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Dates
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Enumeration Date | 03/05/2007
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Last Update Date | 01/21/2010
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Provider Practice Location Address
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Address Line | 9915 WEST MCDOWELL SUITE 106
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City | AVONDALE
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State | AZ
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Zip | 85323
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Country | US
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Telephone | 623-907-4562
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Fax | 623-907-5979
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Provider Business Mailing Address
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Address Line | 2860 MICHELLE 2ND FLOOR
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City | IRVINE
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State | CA
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Zip | 92606-1009
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Country | US
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Telephone | 714-508-3600
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Fax | 714-368-2092
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Authorized Official
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Title or Position | OWNER DOCTOR
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Name | BRIAN D BUEHLER
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Credential | DDS
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Telephone | 623-907-4562
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 1223G0001X
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Taxonomy Name | General Practice Dentistry
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License Number |
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License Number State |
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