Healthcare Provider Details

I. General information

NPI: 1841451663
Provider Name (Legal Business Name): CLAUDIA LIZZETTE GONZALEZ DMD
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 06/24/2008
Last Update Date: 06/24/2008
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3757 HAMILTON CLEVES RD
HAMILTON OH
45013-9557
US

IV. Provider business mailing address

3757 HAMILTON-CLEVES RD
HAMILTON OH
45013
US

V. Phone/Fax

Practice location:
  • Phone: 513-738-4900
  • Fax:
Mailing address:
  • Phone: 513-738-4900
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code122300000X
TaxonomyDentist
License Number30022224
License Number StateOH

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: