Individual
DEBORAH GONZALEZ
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
630 W 168TH ST, NEW YORK, NY 10032-3725
(212) 305-9904
Mailing address
PO BOX 20, 630 W 168TH STREET, NEW YORK, NY 10032-0020
(212) 305-9904
Taxonomy
Speciality
Code
Description
License number
State
124Q00000X
Dental Hygienist
Primary
019575-1
NY
Other
Enumeration date
12/06/2016
Last updated
12/06/2016
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