Provider Demographics
NPI:1154844371
Name:GOMEZ DENTISTRY PLLC
Entity Type:Organization
Organization Name:GOMEZ DENTISTRY PLLC
Other - Org Name:ADVANTAGE DENTAL CENTER
Other - Org Type:Doing Business As
Authorized Official - Title/Position:GENERAL DENTIST/PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:CHRISTOPHER
Authorized Official - Middle Name:
Authorized Official - Last Name:GOMEZ
Authorized Official - Suffix:
Authorized Official - Credentials:DDS
Authorized Official - Phone:786-315-0589
Mailing Address - Street 1:2915 E CERVANTES ST
Mailing Address - Street 2:
Mailing Address - City:PENSACOLA
Mailing Address - State:FL
Mailing Address - Zip Code:32503-6418
Mailing Address - Country:US
Mailing Address - Phone:850-435-3111
Mailing Address - Fax:
Practice Address - Street 1:2915 E CERVANTES ST
Practice Address - Street 2:
Practice Address - City:PENSACOLA
Practice Address - State:FL
Practice Address - Zip Code:32503-6418
Practice Address - Country:US
Practice Address - Phone:850-435-3111
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2017-07-19
Last Update Date:2022-07-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QD0000XAmbulatory Health Care FacilitiesClinic/CenterDental