Individual
DR. IRMA L GONZALEZ
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
DMD
Contact information
Practice address
OFICIANA DENTAL FAMILIAY 1254 SANTANA, ARECIBO, PR 00612
(787) 878-2805
(787) 878-3887
Mailing address
PO BOX 1235, ARECIBO, PR 00613
(787) 878-2805
(787) 878-3887
Taxonomy
Speciality
Code
Description
License number
State
122300000X
Dentist
Primary
2487
PR
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
043021
BCBS
—
01
—
206473
U.T.I.
—
01
—
42470
SSS
—
01
—
6120160
HUMANA
—
01
—
70584
PREFERRED MEDICAL CHOICE
—
Enumeration date
11/14/2006
Last updated
07/08/2007
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