Provider Demographics
NPI:1992892244
Name:GONZALEZ-GONZALEZ, JOSE GILBERTO (DMD)
Entity type:Individual
Prefix:DR
First Name:JOSE
Middle Name:GILBERTO
Last Name:GONZALEZ-GONZALEZ
Suffix:
Gender:M
Credentials:DMD
Other - Prefix:
Other - First Name:
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Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:1 CALLE TAFT
Mailing Address - Street 2:APT. 14-C
Mailing Address - City:SAN JUAN
Mailing Address - State:PR
Mailing Address - Zip Code:00911-1203
Mailing Address - Country:US
Mailing Address - Phone:787-281-0614
Mailing Address - Fax:787-281-0632
Practice Address - Street 1:SUMMIT BUILDING BOX 12 1738 AMARILLO STREET
Practice Address - Street 2:207-A
Practice Address - City:SAN JUAN
Practice Address - State:PR
Practice Address - Zip Code:00926
Practice Address - Country:US
Practice Address - Phone:787-281-0614
Practice Address - Fax:787-281-0632
Is Sole Proprietor?:Yes
Enumeration Date:2006-10-06
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
PR9181223P0300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223P0300XDental ProvidersDentistPeriodontics