Individual
RYAN EMMANUEL GONSALVES
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
DDS
Contact information
Practice address
104 WATERS EDGE CT, MOORESVILLE, NC 28117-5513
(919) 619-4166
Mailing address
104 WATERS EDGE CT, MOORESVILLE, NC 28117-5513
(919) 619-4166
Taxonomy
Speciality
Code
Description
License number
State
122300000X
Dentist
Primary
8414
NC
1223D0001X
Public Health Dentistry
8414
NC
Other
Enumeration date
02/11/2009
Last updated
04/22/2024
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