Provider Demographics
NPI:1306727060
Name:G&G PRESTIGE FAMILY DENTAL PLLC
Entity type:Organization
Organization Name:G&G PRESTIGE FAMILY DENTAL PLLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:MANAGER
Authorized Official - Prefix:DR
Authorized Official - First Name:JORGE
Authorized Official - Middle Name:JULIO
Authorized Official - Last Name:GONZALEZ TEJADA
Authorized Official - Suffix:
Authorized Official - Credentials:DMD
Authorized Official - Phone:305-956-8363
Mailing Address - Street 1:6936 LONG PINE CIR
Mailing Address - Street 2:
Mailing Address - City:COCONUT CREEK
Mailing Address - State:FL
Mailing Address - Zip Code:33073-3079
Mailing Address - Country:US
Mailing Address - Phone:305-956-8363
Mailing Address - Fax:
Practice Address - Street 1:10689 WILES RD
Practice Address - Street 2:
Practice Address - City:CORAL SPRINGS
Practice Address - State:FL
Practice Address - Zip Code:33076-2014
Practice Address - Country:US
Practice Address - Phone:954-345-3439
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2025-09-09
Last Update Date:2025-09-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QD0000XAmbulatory Health Care FacilitiesClinic/CenterDental