Provider Demographics
NPI:1700903184
Name:GONZALEZ, MARIA L (DDS, MS)
Entity Type:Individual
Prefix:DR
First Name:MARIA
Middle Name:L
Last Name:GONZALEZ
Suffix:
Gender:F
Credentials:DDS, MS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3001 MURWORTH DR # 1203
Mailing Address - Street 2:
Mailing Address - City:HOUSTON
Mailing Address - State:TX
Mailing Address - Zip Code:77025-4421
Mailing Address - Country:US
Mailing Address - Phone:713-383-9852
Mailing Address - Fax:
Practice Address - Street 1:10080 BELLAIRE BLVD STE 210
Practice Address - Street 2:
Practice Address - City:HOUSTON
Practice Address - State:TX
Practice Address - Zip Code:77072-5429
Practice Address - Country:US
Practice Address - Phone:281-575-0742
Practice Address - Fax:281-575-0298
Is Sole Proprietor?:Yes
Enumeration Date:2007-03-23
Last Update Date:2015-11-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX218801223P0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223P0700XDental ProvidersDentistProsthodontics
Provider Identifiers
StateIdentifier IDID TypeIssuer
TXA0169922OtherDPS