Provider Demographics
NPI:1750635637
Name:GONZALEZ, ADRIAN OSCAR (DDS)
Entity Type:Individual
Prefix:DR
First Name:ADRIAN
Middle Name:OSCAR
Last Name:GONZALEZ
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 1:4304 ALHAMBRA CIR
Mailing Address - Street 2:
Mailing Address - City:CORAL GABLES
Mailing Address - State:FL
Mailing Address - Zip Code:33146-1012
Mailing Address - Country:US
Mailing Address - Phone:305-258-9838
Mailing Address - Fax:305-257-1982
Practice Address - Street 1:25001 SW 127TH AVE
Practice Address - Street 2:SUITE 208
Practice Address - City:HOMESTEAD
Practice Address - State:FL
Practice Address - Zip Code:33032-5834
Practice Address - Country:US
Practice Address - Phone:305-258-9838
Practice Address - Fax:305-258-9872
Is Sole Proprietor?:Yes
Enumeration Date:2012-10-31
Last Update Date:2012-10-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLDN19996122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist