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NPI Code Detail

MEDICARE: GATEWAY DENTAL COLUMBUS LLC

MEDICARE: GATEWAY DENTAL COLUMBUS LLC
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
11223E0200XEndodonticsIN
2122300000XDentist12010768AIN

General Provider Information

NPI Number : 1891203055
Entity Type Code : Organization
Provider Name (Legal Business Name) : GATEWAY DENTAL COLUMBUS LLC
Provider Business Mailing Address
First Line : 2459 W JONATHAN MOORE PIKE
Second Line :
City : COLUMBUS
State : IN
Zip : 47201-9206
Country : US
Telephone Number : 812-669-0123
Fax Number :
Provider Business Practice Location Address
First Line : 2459 W JONATHAN MOORE PIKE
Second Line :
City : COLUMBUS
State : IN
Zip : 47201-9206
Country : US
Telephone Number : 812-669-0123
Fax Number :
Authorized Official
Title or Position : OWNER/PRESIDENT
Name : DR. AARON WAYNE STRICKLAND
Credential : DDS
Telephone Number : 812-669-0123
Provider Enumeration Date : 01/22/2018
Last Update Date : 01/22/2018

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Directions to “GATEWAY DENTAL COLUMBUS LLC ” Practice Location

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