Individual
MIRIAM GONZALEZ
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
DMD
Contact information
Practice address
801 NORTH 2ND AVE, SAN LUIS, AZ 85349
(928) 627-8584
(928) 627-8949
Mailing address
2060 W 24TH ST, YUMA, AZ 85364-6123
(928) 819-8834
(928) 539-5579
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
9492
AZ
Other
Enumeration date
07/28/2016
Last updated
07/28/2016
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