Provider Demographics
NPI:1780352278
Name:GONZALEZ-PANECA, RENE ORLANDO (DDS)
Entity type:Individual
Prefix:
First Name:RENE
Middle Name:ORLANDO
Last Name:GONZALEZ-PANECA
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 1:30643 FM 2978 RD BLDG B
Mailing Address - Street 2:
Mailing Address - City:MAGNOLIA
Mailing Address - State:TX
Mailing Address - Zip Code:77354-2316
Mailing Address - Country:US
Mailing Address - Phone:281-817-6300
Mailing Address - Fax:281-817-6313
Practice Address - Street 1:30643 FM 2978 RD BLDG B
Practice Address - Street 2:
Practice Address - City:MAGNOLIA
Practice Address - State:TX
Practice Address - Zip Code:77354-2316
Practice Address - Country:US
Practice Address - Phone:210-202-1604
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2021-08-31
Last Update Date:2024-09-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX37833122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist