Organization
INTEGRAL DENTAL GROUP, INC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. HANSEL GONZALEZ D.M.D (PRESIDENT)
(305) 649-6112
Entity
Organization
Contact information
Practice address
1125 NW 22ND AVE, MIAMI, FL 33125-2738
(305) 649-6112
(305) 649-1803
Mailing address
1125 NW 22ND AVE, MIAMI, FL 33125-2738
(305) 649-6112
(305) 649-1803
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
DN19852
FL
Other
Enumeration date
04/02/2014
Last updated
04/02/2014
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