Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 126800000X | Dental Assistant |
NPI | 1073751582 |
---|---|
Provider Name | Belem Gonzalez |
First Address | Bell, CA 90201-3611 |
Second Address | Bell, CA 90201-3611 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 22/01/2009 |
Last Update Date | 22/01/2009 |