Individual
ISRAEL GONZALEZ
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
RDAEF
Contact information
Practice address
411 4TH ST, SAN RAFAEL, CA 94901-5716
(415) 473-5450
(415) 473-5460
Mailing address
411 4TH ST, SAN RAFAEL, CA 94901-5716
(415) 473-5450
(415) 473-5460
Taxonomy
Speciality
Code
Description
License number
State
126800000X
Dental Assistant
Primary
1484
CA
Other
Enumeration date
03/18/2010
Last updated
03/18/2010
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