Doctor Name: | DR. CESAR D GONZALEZ |
NPI Number: | 1023005972 |
Entity Type Code: | Individual (1) |
Gender: | M |
Credentials: | DDS |
License Number: | 5379-015 |
Business Practice Address: | 4536 22nd Ave Kenosha, WI - 531405917 |
Business Phone Number: | 2626560044 |
Business Fax Number: | 2626532218 |
Mailing Address: | 13020 Golf Pkwy, BROOKFIELD |
State: | WI |
Postal Code: | 530058025 |
Phone Number: | 2629383208 |
Fax Number: | |
NPI Enumeration Date: | 10/04/2005 |
NPI Last Update Date: | 07/08/2007 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 1223P0221X |
License Number: | 5379-015 |
Healthcare Provider Taxonomy: (Secondary) | Y |
State: | WI |
Taxonomy Type: | Dental Providers |
Taxonomy Classification: | Dentist |
Taxonomy Specialization: | Pediatric Dentistry |
Taxonomy Definition: | An age-defined specialty that provides both primary and comprehensive preventive and therapeutic oral health care for infants and children through adolescence, including those with special health care needs. |