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General NPI Number Information
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NPI Number | 1649432436
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Entity Type | Individual
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Provider Name | REFUGIO GONZALEZ III DDS
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Gender | Male
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Dates
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Enumeration Date | 07/02/2008
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Last Update Date | 09/03/2020
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Provider Practice Location Address
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Address Line | 8131 DORADO DR
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City | ODESSA
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State | TX
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Zip | 79765-8533
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Country | US
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Telephone | 432-272-1190
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Fax | 800-532-0728
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Provider Business Mailing Address
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Address Line | 13725 NORTHWEST BLVD STE 270
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City | CORPUS CHRISTI
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State | TX
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Zip | 78410-5123
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Country | US
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Telephone | 361-992-9500
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Fax |
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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 | 1223P0221X
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Taxonomy Name | Pediatric Dentistry
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License Number | 9957
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License Number State | NC
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Taxonomy #2
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Taxonomy Code | 390200000X
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Taxonomy Name | Student in an Organized Health Care Education/Training Program
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License Number |
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License Number State |
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Taxonomy #3
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Taxonomy Code | 1223P0221X
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Taxonomy Name | Pediatric Dentistry
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License Number | 23919
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License Number State | TX
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