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General NPI Number Information
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NPI Number | 1912458670
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Entity Type | Individual
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Provider Name | MARIA MERCEDES GONZALEZ-COOK DDS
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Gender | Female
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Dates
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Enumeration Date | 10/18/2016
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Last Update Date | 09/18/2020
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Provider Practice Location Address
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Address Line | 31796 COAST HWY
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City | LAGUNA BEACH
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State | CA
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Zip | 92651-6974
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Country | US
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Telephone | 949-415-1020
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Fax |
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Provider Business Mailing Address
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Address Line | 5307 W TONOPAH DR
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City | GLENDALE
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State | AZ
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Zip | 85308-9119
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Country | US
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Telephone | 949-573-4091
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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 | 122300000X
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Taxonomy Name | Dentist
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License Number | 41410
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License Number State | CA
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