Provider Demographics
NPI:1093006082
Name:GOMEZ, GERZAIN WHITNEY (DDS)
Entity Type:Individual
Prefix:
First Name:GERZAIN
Middle Name:WHITNEY
Last Name:GOMEZ
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 1:1320 FRANKLIN AVE
Mailing Address - Street 2:ALBRITTON DENTAL ASSOCIATES
Mailing Address - City:NEDERLAND
Mailing Address - State:TX
Mailing Address - Zip Code:77627
Mailing Address - Country:US
Mailing Address - Phone:409-727-6453
Mailing Address - Fax:409-722-4322
Practice Address - Street 1:1320 FRANKLIN AVE
Practice Address - Street 2:ALBRITTON DENTAL ASSOCIATES
Practice Address - City:NEDERLAND
Practice Address - State:TX
Practice Address - Zip Code:77627
Practice Address - Country:US
Practice Address - Phone:409-727-6453
Practice Address - Fax:409-722-4322
Is Sole Proprietor?:No
Enumeration Date:2011-04-25
Last Update Date:2011-04-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX246511223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice