Organization
GONZALES DENTAL CORPORATION
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. THOMAS RICHARD GONZALES DDS (PRESIDENT)
(858) 521-0000
Entity
Organization
Contact information
Practice address
11968 BERNARDO PLAZA DRIVE, SAN DIEGO, CA 92128
(858) 521-0000
(858) 521-0404
Mailing address
11968 BERNARDO PLAZA DRIVE, SAN DIEGO, CA 92128
(858) 521-0000
(858) 521-0404
Taxonomy
Speciality
Code
Description
License number
State
302R00000X
Health Maintenance Organization
Primary
26408
CA
Other
Enumeration date
09/10/2015
Last updated
11/13/2015
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