Provider Demographics
NPI:1689917072
Name:GONZALEZ-ESPINOZA, CARLOS EDUARDO (DDS)
Entity Type:Individual
Prefix:MR
First Name:CARLOS
Middle Name:EDUARDO
Last Name:GONZALEZ-ESPINOZA
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 1:155 5TH ST
Mailing Address - Street 2:FACULTY PRACTICE
Mailing Address - City:SAN FRANCISCO
Mailing Address - State:CA
Mailing Address - Zip Code:94103-2919
Mailing Address - Country:US
Mailing Address - Phone:415-749-3351
Mailing Address - Fax:
Practice Address - Street 1:155 5TH ST
Practice Address - Street 2:FACULTY PRACTICE
Practice Address - City:SAN FRANCISCO
Practice Address - State:CA
Practice Address - Zip Code:94103-2919
Practice Address - Country:US
Practice Address - Phone:415-749-3351
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2013-04-03
Last Update Date:2016-07-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CASP 258122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist