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General NPI Number Information
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NPI Number | 1467671164
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Entity Type | Individual
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Provider Name | GEORGE GOROSPE SOLANZO D.M.D.
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Gender | Male
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Dates
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Enumeration Date | 04/24/2007
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Last Update Date | 07/08/2007
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Provider Practice Location Address
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Address Line | 2664 BERRYESSA RD STE 214
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City | SAN JOSE
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State | CA
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Zip | 95132-2907
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Country | US
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Telephone | 408-272-1141
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Fax | 408-272-9039
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Provider Business Mailing Address
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Address Line | 2664 BERRYESSA RD STE 214
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City | SAN JOSE
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State | CA
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Zip | 95132-2907
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Country | US
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Telephone | 408-272-1141
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Fax | 408-272-9039
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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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 | 40017
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License Number State | CA
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