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General NPI Number Information
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NPI Number | 1528657640
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Entity Type | Organization
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Legal Business Name | DR PEDRO GONZALEZ DDS A DENTAL CORPORATION
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Dates
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Enumeration Date | 01/13/2021
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Last Update Date | 01/13/2021
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Provider Practice Location Address
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Address Line | 15027 MULBERRY DR
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City | WHITTIER
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State | CA
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Zip | 90604-1528
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Country | US
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Telephone | 562-351-1012
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Fax |
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Provider Business Mailing Address
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Address Line | 15027 MULBERRY DR
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City | WHITTIER
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State | CA
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Zip | 90604-1528
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Country | US
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Telephone | 562-351-1012
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Fax |
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Authorized Official
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Title or Position | DENTAL MANAGER OF OPERATIONS
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Name | MRS. GRISELDA MONTES
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Credential |
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Telephone | 562-716-4348
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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 |
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License Number State |
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