Provider Demographics
NPI:1255349577
Name:GONZALEZ, JUAN FRANCISCO (DDS)
Entity type:Individual
Prefix:DR
First Name:JUAN
Middle Name:FRANCISCO
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 1:2211 S MAIN ST
Mailing Address - Street 2:
Mailing Address - City:SANTA ANA
Mailing Address - State:CA
Mailing Address - Zip Code:92707-3219
Mailing Address - Country:US
Mailing Address - Phone:714-751-7155
Mailing Address - Fax:714-751-1435
Practice Address - Street 1:2211 S MAIN ST
Practice Address - Street 2:
Practice Address - City:SANTA ANA
Practice Address - State:CA
Practice Address - Zip Code:92707-3219
Practice Address - Country:US
Practice Address - Phone:714-751-7155
Practice Address - Fax:714-751-1435
Is Sole Proprietor?:Yes
Enumeration Date:2006-08-03
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA463871223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice