Individual
DR. JOHN PHILLIP GONZALES
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
D.D.S.
Contact information
Practice address
200 W. HOSPITAL DRIVE, WHITERIVER, AZ 85941
(928) 338-4911
Mailing address
200 W. HOSPITAL DRIVE, WHITERIVER, AZ 85941
(928) 338-4911
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
1859
ND
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
000001859ND
DELTA DENTAL USA
ND
05
—
041327
—
ND
01
—
23946
BLUE CROSS BLUE SHIELD
ND
01
—
949039
DENTAL SERVICE CORP.
ND
Enumeration date
03/21/2007
Last updated
03/20/2026
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