Provider Demographics
NPI:1205078631
Name:GONZALEZ, ARTURO (DDS)
Entity type:Individual
Prefix:DR
First Name:ARTURO
Middle Name:
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 1:995 ROSAL CT
Mailing Address - Street 2:
Mailing Address - City:CHULA VISTA
Mailing Address - State:CA
Mailing Address - Zip Code:91910-8030
Mailing Address - Country:US
Mailing Address - Phone:619-739-4365
Mailing Address - Fax:619-271-2006
Practice Address - Street 1:MISION DE LORETO # 2962-204
Practice Address - Street 2:
Practice Address - City:TIJUANA
Practice Address - State:B.C
Practice Address - Zip Code:22010
Practice Address - Country:MX
Practice Address - Phone:664-634-2060
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2009-03-31
Last Update Date:2009-03-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
ZZDGP5561341223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice