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Organization
M SYLVESTER GONZALES DDS PA
Active
Organization
M SYLVESTER GONZALES DDS PA
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. MANUEL SYLVESTER GONZALES DDS (PRESIDENT)
(512) 501-4020
Entity
Organization
Contact information
Practice address
4010 SANDY BROOK DR. #104, ROUND ROCK, TX 78665-1517
(512) 501-4020
(512) 501-4020
Mailing address
4010 SANDY BROOK DR. #104, ROUND ROCK, TX 78665-1517
(512) 501-4020
(512) 501-4021
Taxonomy
Speciality
Code
Description
License number
State
122300000X
Dentist
Primary
22311
TX
332BC3200X
Customized Equipment (DME)
22311
TX
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
1053437814
NPI
TX
Enumeration date
04/09/2015
Last updated
05/21/2015
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