Individual
ASIAH JEANMARIE GONZALEZ
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
LDT
Contact information
Practice address
17395 RESERVATION RD, LA CONNER, WA 98257-8802
(360) 466-3900
Mailing address
17395 RESERVATION RD, LA CONNER, WA 98257-8802
(360) 466-3900
Taxonomy
Speciality
Code
Description
License number
State
125J00000X
Dental Therapist
Primary
19-TDT-02
WA
Other
Enumeration date
02/02/2021
Last updated
02/02/2021
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