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Organization
STAR CITY DENTAL
Active
Organization
STAR CITY DENTAL
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. JUAN M GONZALEZ D.D.S. (OWNER/DENTIST)
(915) 591-7117
Entity
Organization
Contact information
Practice address
1806 MCRAE BLVD, EL PASO, TX 79925-6706
(915) 591-7117
Mailing address
1806 MCRAE BLVD, EL PASO, TX 79925-6706
(915) 591-7117
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
11348
TX
Other
Enumeration date
09/13/2016
Last updated
09/13/2016
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