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General NPI Number Information
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NPI Number | 1407911472
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Entity Type | Organization
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Legal Business Name | YOLANDA D GONZALES DMD INC
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Dates
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Enumeration Date | 12/27/2006
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Last Update Date | 08/22/2020
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Provider Practice Location Address
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Address Line | 2378 FRUITRIDGE RD
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City | SACRAMENTO
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State | CA
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Zip | 95822
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Country | US
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Telephone | 916-421-1010
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Fax | 916-421-5380
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Provider Business Mailing Address
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Address Line | 2378 FRUITRIDGE RD
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City | SACRAMENTO
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State | CA
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Zip | 95822-3148
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Country | US
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Telephone | 916-421-1010
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Fax | 916-421-5380
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Authorized Official
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Title or Position | DENTIST
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Name | DR. YOLANDA DELFIN GONZALES
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Credential | DMD
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Telephone | 916-421-1010
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 122300000X
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Taxonomy Name | Dentist
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License Number | 40440
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License Number State | CA
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