Organization
KELLY M. GONZALES, DDS, PC
Active
Other names
Star Smiles Pediatric Dentistry
Organization subpart
No
Provider details
NPI number
Authorized official
DR. KELLY MARIE GONZALES DDS (PRESIDENT)
(512) 864-9595
Entity
Organization
Contact information
Practice address
1103 RIVERY BLVD, STE 140, GEORGETOWN, TX 78628-3034
(512) 864-9595
Mailing address
1103 RIVERY BLVD, STE 140, GEORGETOWN, TX 78628-3034
(512) 864-9595
Taxonomy
Speciality
Code
Description
License number
State
1223P0221X
Pediatric Dentistry
Primary
—
—
Other
Enumeration date
04/14/2008
Last updated
09/23/2009
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