Provider Demographics
NPI:1174645766
Name:GONZALEZ GARCIA, RAMON FERNANDO (DDS)
Entity Type:Individual
Prefix:DR
First Name:RAMON
Middle Name:FERNANDO
Last Name:GONZALEZ GARCIA
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 1:87 CARR 20 APT 602
Mailing Address - Street 2:
Mailing Address - City:GUAYNABO
Mailing Address - State:PR
Mailing Address - Zip Code:00966-4041
Mailing Address - Country:US
Mailing Address - Phone:787-774-0815
Mailing Address - Fax:
Practice Address - Street 1:1162 CALLE BRUMBAUGH
Practice Address - Street 2:URB. GARCIA UBARRI
Practice Address - City:RIO PIEDRAS
Practice Address - State:PR
Practice Address - Zip Code:00925-3608
Practice Address - Country:US
Practice Address - Phone:787-753-9443
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-04-04
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PR21851223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice