Organization Name: | GATES DENTAL CARE PC |
NPI Number: | 1962449850 |
Entity Type Code: | Organizational (2) |
Authorized Official Name: | GAMAL S. NAGUIB (PRESIDENT) |
Mailing Address: | 927 S Mannheim Rd Westchester |
State: | IL US |
Postal Code: | 601542565 |
Phone Number: | 8479671149 |
Fax Number: | 8479678594 |
NPI Enumeration Date: | 06/01/2006 |
NPI Last Update Date: | 11/10/2007 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 204E00000X |
License Number: | |
Healthcare Provider Taxonomy: (Secondary) | Y |
State: | IL |
Taxonomy Type: | Allopathic & Osteopathic Physicians |
Taxonomy Classification: | Oral & Maxillofacial Surgery |
Taxonomy Specialization: | |
Taxonomy Definition: |