Individual
DR. ASHLEY NICOLE IRIZARRY GONZALEZ
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
DMD
Contact information
Practice address
4014 14TH ST W, BRADENTON, FL 00956
(941) 708-6504
Mailing address
200 CALLE ALCALA APT 503, SAN JUAN, PR 00921-3937
(787) 514-2652
Taxonomy
Speciality
Code
Description
License number
State
122300000X
Dentist
003431
PR
122300000X
Dentist
27812
FL
1223G0001X
General Practice Dentistry
003431
PR
1223G0001X
General Practice Dentistry
Primary
27812
FL
1223X2210X
Orofacial Pain Dentistry
003431
PR
1223X2210X
Orofacial Pain Dentistry
27812
FL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
403153972
STUDENT ID
—
Enumeration date
10/19/2021
Last updated
05/30/2023
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