Provider Demographics
NPI:1720132913
Name:GONZALEZ, ARNALDO (DDS)
Entity type:Individual
Prefix:DR
First Name:ARNALDO
Middle Name:
Last Name:GONZALEZ
Suffix:
Gender:M
Credentials:DDS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2139 TAPO STREET
Mailing Address - Street 2:101
Mailing Address - City:SIMI VALLEY
Mailing Address - State:CA
Mailing Address - Zip Code:93063-3486
Mailing Address - Country:US
Mailing Address - Phone:805-582-2571
Mailing Address - Fax:805-583-3626
Practice Address - Street 1:2139 TAPO STREET
Practice Address - Street 2:101
Practice Address - City:SIMI VALLEY
Practice Address - State:CA
Practice Address - Zip Code:93063-3486
Practice Address - Country:US
Practice Address - Phone:805-582-2571
Practice Address - Fax:805-583-3626
Is Sole Proprietor?:No
Enumeration Date:2007-01-23
Last Update Date:2010-09-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA523921223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice