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General NPI Number Information
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NPI Number | 1861713133
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Entity Type | Organization
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Legal Business Name | RUBEN V. GONZALEZ DDS INC
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Dates
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Enumeration Date | 06/21/2010
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Last Update Date | 06/21/2010
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Provider Practice Location Address
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Address Line | 711 W WHITTER BLVD
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City | MONTEBELLO
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State | CA
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Zip | 90640-4709
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Country | US
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Telephone | 323-278-0170
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Fax | 323-278-1129
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Provider Business Mailing Address
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Address Line | 711 W. WHITTER BLVD
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City | MONTEBELLO
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State | CA
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Zip | 90640-4709
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Country | US
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Telephone | 323-278-0170
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Fax | 323-278-1129
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Authorized Official
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Title or Position | PRESIDENT
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Name | DR. RUBEN V GONZALEZ
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Credential | DDS
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Telephone | 323-278-0170
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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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