| NPI | 1447733555 |
|---|---|
| Former Legal Business Name | TANIA J GONZALEZ |
| Entity Type | Organization |
| Authorized Contact | TANIA J GONZALEZ Dentist 619-488-3200 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1223G0001X Dentist, General Practice |
| Enumeration Date | 2018-09-13 |
| Last Update Date | 2018-09-13 |