Provider Demographics
NPI:1336386572
Name:STEVEN GONZALES DDS PC
Entity Type:Organization
Organization Name:STEVEN GONZALES DDS PC
Other - Org Name:FAMILY AND COSMETIC DOCTOR OF DENTISTRY
Other - Org Type:Doing Business As
Authorized Official - Title/Position:DENTIST/PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:STEVEN
Authorized Official - Middle Name:
Authorized Official - Last Name:GONZALES
Authorized Official - Suffix:
Authorized Official - Credentials:DDS
Authorized Official - Phone:903-521-5954
Mailing Address - Street 1:2120 W SPRING CREEK PKWY
Mailing Address - Street 2:SUITE C
Mailing Address - City:PLANO
Mailing Address - State:TX
Mailing Address - Zip Code:75023-4187
Mailing Address - Country:US
Mailing Address - Phone:469-429-0094
Mailing Address - Fax:469-429-4442
Practice Address - Street 1:2120 W SPRING CREEK PKWY
Practice Address - Street 2:SUITE C
Practice Address - City:PLANO
Practice Address - State:TX
Practice Address - Zip Code:75023-4187
Practice Address - Country:US
Practice Address - Phone:469-429-0094
Practice Address - Fax:469-429-4442
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2009-01-09
Last Update Date:2009-02-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX23576261QD0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QD0000XAmbulatory Health Care FacilitiesClinic/CenterDental