Individual
MATTHEW JAMES GONZALES
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
BSDH, RDH, EPDH
Contact information
Practice address
3300 SE DWYER DR STE 302, MILWAUKIE, OR 97222-6548
(503) 850-4479
Mailing address
6420 SW MACADAM AVE STE 300, PORTLAND, OR 97239-3519
(503) 941-3077
Taxonomy
Speciality
Code
Description
License number
State
124Q00000X
Dental Hygienist
Primary
H7750
OR
Other
Enumeration date
10/22/2018
Last updated
10/22/2018
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