Individual
GARRET GONZALES
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
DDS
Contact information
Practice address
4171 CRESCENT DR STE 102, SAINT LOUIS, MO 63129-3645
(314) 200-3880
Mailing address
9616 BENT PINE DR APT A, SAPPINGTON, MO 63126-3346
(208) 420-4213
Taxonomy
Speciality
Code
Description
License number
State
122300000X
Dentist
Primary
2025049199
MO
Other
Enumeration date
11/24/2025
Last updated
11/24/2025
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