Provider Demographics
NPI:1194346890
Name:GONZALEZ, ANA MARIA (DDS)
Entity type:Individual
Prefix:DR
First Name:ANA
Middle Name:MARIA
Last Name:GONZALEZ
Suffix:
Gender:F
Credentials:DDS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4181 FRYER ST
Mailing Address - Street 2:
Mailing Address - City:THE COLONY
Mailing Address - State:TX
Mailing Address - Zip Code:75056-3653
Mailing Address - Country:US
Mailing Address - Phone:469-379-5029
Mailing Address - Fax:
Practice Address - Street 1:1600 US HIGHWAY 287
Practice Address - Street 2:SUITE 102
Practice Address - City:MANSFIELD
Practice Address - State:TX
Practice Address - Zip Code:76063
Practice Address - Country:US
Practice Address - Phone:817-473-9501
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2020-05-04
Last Update Date:2020-05-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX35712122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist