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Organization

EDELIO GONZALEZ DMD, PA

Active
Organization subpart
No

Provider details

NPI number
Authorized official
EDELIO GONZALEZ DMD (PRESIDENT)
(305) 826-9642
Entity
Organization

Contact information

Practice address
1191 W 37TH ST, 5, HIALEAH, FL 33012-4941
(305) 826-9642
(305) 819-8014
Mailing address
1191 W 37TH ST, 5, HIALEAH, FL 33012-4941
(305) 826-9642
(305) 819-8014

Taxonomy

Speciality
Code
Description
License number
State
122300000X
Dentist
Primary
DN00013074
FL

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
0171853000
FL
Enumeration date
09/28/2006
Last updated
08/22/2020
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