Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 1223P0300X | Periodontist | 6376 | FL |
NPI | 1093920845 |
---|---|
Provider Name | Dr. Edward Francis Gonsky |
First Address | Boca Raton, FL 33486-1323 |
Second Address | Boca Raton, FL 33486-1323 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 14/05/2007 |
Last Update Date | 08/07/2007 |