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Individual
DR. JUAN RAFAEL GONZALEZ
Active
Individual
DR. JUAN RAFAEL GONZALEZ
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
DMD
Taxonomy
Speciality
Code
Description
License number
State
122300000X
Dentist
019-022361
IL
122300000X
Dentist
042540
NY
122300000X
Dentist
17336-9
TX
122300000X
Dentist
Primary
30-022496
OH
122300000X
Dentist
856
PR
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
008682
REGISTRATION NUM.
PR
01
—
856
DENTAL LICENCE
PR
Enumeration date
08/15/2006
Last updated
07/12/2012
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