Individual
DR. JUAN FERNANDO GONZALEZ
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
DMD
Contact information
Practice address
4010 SANDY BROOK DR STE 204, ROUND ROCK, TX 78665-1518
(512) 375-0050
(512) 682-9009
Mailing address
4010 SANDY BROOK DR STE 204, ROUND ROCK, TX 78665-1518
(512) 375-0050
(512) 682-9009
Taxonomy
Speciality
Code
Description
License number
State
1223S0112X
Oral and Maxillofacial Surgery (Dentist)
Primary
22953
TX
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
218656102
—
TX
01
—
22953
LICENSE
TX
Enumeration date
04/04/2006
Last updated
12/23/2020
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