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General NPI Number Information
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NPI Number | 1891104469
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Entity Type | Organization
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Legal Business Name | MARIA GONZALEZ-FUJARA DDS, PA
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Dates
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Enumeration Date | 08/08/2014
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Last Update Date | 08/08/2014
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Provider Practice Location Address
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Address Line | 625 SE 2ND AVE STE D
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City | BOYNTON BEACH
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State | FL
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Zip | 33435-5065
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Country | US
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Telephone | 561-739-3222
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Fax | 561-336-3532
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Provider Business Mailing Address
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Address Line | 625 SE 2ND AVE STE D
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City | BOYNTON BEACH
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State | FL
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Zip | 33435-5065
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Country | US
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Telephone | 561-739-3222
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Fax | 561-336-3532
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Authorized Official
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Title or Position | DENTIST/OWNER
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Name | MARIA GONZALEZ-FUJARA
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Credential | DDS
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Telephone | 561-739-3222
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 1223G0001X
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Taxonomy Name | General Practice Dentistry
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License Number | DN14857
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License Number State | FL
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