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General NPI Number Information
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NPI Number | 1336386572
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Entity Type | Organization
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Legal Business Name | STEVEN GONZALES DDS PC
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Dates
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Enumeration Date | 01/09/2009
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Last Update Date | 02/05/2009
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Provider Practice Location Address
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Address Line | 2120 W SPRING CREEK PKWY SUITE C
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City | PLANO
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State | TX
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Zip | 75023-4187
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Country | US
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Telephone | 469-429-0094
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Fax | 469-429-4442
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Provider Business Mailing Address
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Address Line | 2120 W SPRING CREEK PKWY SUITE C
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City | PLANO
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State | TX
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Zip | 75023-4187
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Country | US
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Telephone | 469-429-0094
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Fax | 469-429-4442
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Authorized Official
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Title or Position | DENTIST/PRESIDENT
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Name | DR. STEVEN GONZALES
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Credential | DDS
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Telephone | 903-521-5954
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261QD0000X
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Taxonomy Name | Dental Clinic/Center
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License Number | 23576
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License Number State | TX
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