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Individual

CARLOS A GARZA GONGORA

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
DDS

Contact information

Practice address
2320 TOWNE LAKE PARKWAY, BUILDING 1300 STE 100, WOODSTOCK, GA 30189
(678) 445-5444
(678) 445-5552
Mailing address
2320 TOWNE LAKE PARKWAY, BUILDING 1300 STE 100, WOODSTOCK, GA 30189
(678) 445-5444
(678) 445-5552

Taxonomy

Speciality
Code
Description
License number
State
1223P0221X
Pediatric Dentistry
DN013700
GA
390200000X
Student in an Organized Health Care Education/Training Program
Primary

Other

Enumeration date
09/20/2006
Last updated
08/14/2008
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