Organization
THOMAS R GONZALES, D.D.S.
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. THOMAS RICHARD GONZALES D.D.S. (DENTIST)
(702) 798-6684
Entity
Organization
Contact information
Practice address
11506 BROADWAY, WHITTIER, CA 90601-3105
(562) 695-8718
Mailing address
11506 BROADWAY, WHITTIER, CA 90601-3105
Taxonomy
Speciality
Code
Description
License number
State
332BC3200X
Customized Equipment (DME)
Primary
2427
NV
Other
Enumeration date
06/04/2010
Last updated
06/04/2010
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