Provider Demographics
NPI:1316152135
Name:GONZALEZ, MARIA EUGENIA (DDS)
Entity type:Individual
Prefix:DR
First Name:MARIA
Middle Name:EUGENIA
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 1:1 KNEELAND ST
Mailing Address - Street 2:TUFTS DENTAL ASSOCIATES. 8TH. FLOOR
Mailing Address - City:BOSTON
Mailing Address - State:MA
Mailing Address - Zip Code:02111-1527
Mailing Address - Country:US
Mailing Address - Phone:617-636-6697
Mailing Address - Fax:617-636-3585
Practice Address - Street 1:1 KNEELAND ST
Practice Address - Street 2:TUFTS DENTAL ASSOCIATES. 8TH. FLOOR
Practice Address - City:BOSTON
Practice Address - State:MA
Practice Address - Zip Code:02111-1527
Practice Address - Country:US
Practice Address - Phone:617-636-6697
Practice Address - Fax:617-636-3585
Is Sole Proprietor?:No
Enumeration Date:2007-05-14
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MA9363122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist