Gateway Dental Clinic, PC

NPI #1295031813 in Portland, Oregon

Provider Information

NPI Number: 1295031813
Entity Type: Organization
Organization Name: Gateway Dental Clinic, PC
Primary Specialty: Dentist - General Practice
Enumeration Date: Jan 28, 2011
Last Updated: Jan 28, 2011

Practice Location

Address: 10305 NE HALSEY ST
City: Portland
State: Oregon
ZIP Code: 97220-3954
Phone: (503) 252-0048

Authorized Official

Name: DR. JOSEF SEDIVY, DDS
Title: PRESIDENT
Phone: (503) 252-0048

Specialties & Taxonomy Codes

Specialty	Taxonomy Code	Primary
Dentist - General Practice — General Practice	1223G0001X	Primary

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