Organization
THOMAS GONZALES DENTAL CORP
Active
Organization subpart
No
Provider details
NPI number
Authorized official
THOMAS GONZALES DDS (PRESIDENT)
(949) 727-0777
Entity
Organization
Contact information
Practice address
113 WATERWORKS WAY, SUITE 220, IRVINE, CA 92618-3167
(949) 727-0777
Mailing address
113 WATERWORKS WAY, SUITE 220, IRVINE, CA 92618-3167
(949) 727-0777
Taxonomy
Speciality
Code
Description
License number
State
332BC3200X
Customized Equipment (DME)
Primary
26408
CA
Other
Enumeration date
04/01/2011
Last updated
04/01/2011
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