Provider Demographics
NPI:1922313659
Name:GOMEZ, RENE LOZANO (DDS)
Entity Type:Individual
Prefix:MR
First Name:RENE
Middle Name:LOZANO
Last Name:GOMEZ
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 1:770 JOSEPHINE ST
Mailing Address - Street 2:
Mailing Address - City:SALINAS
Mailing Address - State:CA
Mailing Address - Zip Code:93905-1523
Mailing Address - Country:US
Mailing Address - Phone:831-320-9370
Mailing Address - Fax:
Practice Address - Street 1:770 JOSEPHINE ST
Practice Address - Street 2:
Practice Address - City:SALINAS
Practice Address - State:CA
Practice Address - Zip Code:93905-1523
Practice Address - Country:US
Practice Address - Phone:831-320-9370
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2010-08-18
Last Update Date:2010-08-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA597011223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice