Provider Demographics
NPI:1932569688
Name:GONZALEZ, MARIA (DDS)
Entity Type:Individual
Prefix:
First Name:MARIA
Middle Name:
Last Name:GONZALEZ
Suffix:
Gender:F
Credentials:DDS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3988 MISSION ST
Mailing Address - Street 2:
Mailing Address - City:SAN FRANCISCO
Mailing Address - State:CA
Mailing Address - Zip Code:94112-1050
Mailing Address - Country:US
Mailing Address - Phone:415-334-4554
Mailing Address - Fax:415-333-4243
Practice Address - Street 1:3988 MISSION ST
Practice Address - Street 2:
Practice Address - City:SAN FRANCISCO
Practice Address - State:CA
Practice Address - Zip Code:94112-1050
Practice Address - Country:US
Practice Address - Phone:415-334-4554
Practice Address - Fax:415-333-4243
Is Sole Proprietor?:No
Enumeration Date:2016-02-23
Last Update Date:2016-02-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA58535122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist