Individual
NATALIE GOMEZ
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
2330 SIOUX TRL NW, PRIOR LAKE, MN 55372-9077
(952) 496-6148
Mailing address
2330 SIOUX TRL NW, PRIOR LAKE, MN 55372-9077
Taxonomy
Speciality
Code
Description
License number
State
122300000X
Dentist
Primary
D13585
MN
1223G0001X
General Practice Dentistry
D13585
MN
Other
Enumeration date
04/11/2016
Last updated
08/14/2025
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