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Organization
RUSO
Active
Organization
RUSO
Active
Organization subpart
No
Provider details
NPI number
Authorized official
RUBEN GONZALEZ (PRESIDENT)
(323) 278-0170
Entity
Organization
Contact information
Practice address
9535 GARDEN GROVE BLVD, GARDEN GROVE, CA 92844-1550
(714) 855-1138
Mailing address
9535 GARDEN GROVE BLVD, GARDEN GROVE, CA 92844-1550
(714) 855-1138
Taxonomy
Speciality
Code
Description
License number
State
122300000X
Dentist
Primary
B33928
CA
Other
Enumeration date
06/15/2016
Last updated
06/15/2016
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