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General NPI Number Information
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NPI Number | 1427839208
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Entity Type | Organization
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Legal Business Name | M CECILIA GONZALEZ DDS A PROF CORP
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Dates
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Enumeration Date | 10/09/2023
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Last Update Date | 10/09/2023
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Provider Practice Location Address
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Address Line | 15952 PERRIS BLVD STE E
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City | MORENO VALLEY
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State | CA
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Zip | 92551-1320
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Country | US
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Telephone | 951-243-0282
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Fax | 951-243-1457
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Provider Business Mailing Address
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Address Line | 15952 PERRIS BLVD STE E
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City | MORENO VALLEY
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State | CA
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Zip | 92551-1320
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Country | US
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Telephone | 951-243-0282
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Fax | 951-243-1457
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Authorized Official
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Title or Position | OWNER PRESIDENT
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Name | DR. MARIA C GONZALEZ
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Credential | DDS
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Telephone | 951-970-7934
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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 |
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License Number State |
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