Provider Demographics
NPI:1245412808
Name:GONZALEZ-ASCAR, MIGUEL A (DMD, MS)
Entity Type:Individual
Prefix:
First Name:MIGUEL
Middle Name:A
Last Name:GONZALEZ-ASCAR
Suffix:
Gender:M
Credentials:DMD, MS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:Z30 AVE LAUREL
Mailing Address - Street 2:URB. LOMAS VERDES
Mailing Address - City:BAYAMON
Mailing Address - State:PR
Mailing Address - Zip Code:00956-3244
Mailing Address - Country:US
Mailing Address - Phone:787-787-2384
Mailing Address - Fax:
Practice Address - Street 1:Z30 AVE LAUREL
Practice Address - Street 2:URB. LOMAS VERDES
Practice Address - City:BAYAMON
Practice Address - State:PR
Practice Address - Zip Code:00956-3244
Practice Address - Country:US
Practice Address - Phone:787-787-2384
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2007-12-05
Last Update Date:2017-03-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PR27861223P0300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223P0300XDental ProvidersDentistPeriodontics