DR. Edward Johann Gonzalez, DDS

NPI #1790920916 in Eglin Afb, Florida

Provider Information

NPI Number: 1790920916
Entity Type: Individual
Name: DR. Edward Johann Gonzalez, DDS
Gender: Not Specified
Sole Proprietor: No
Primary Specialty: Dentist
Credential: DDS
Enumeration Date: Dec 3, 2008
Last Updated: Sep 29, 2009

Practice Location

Address: 307 BOATNER RD STE 114
Address 2: 96TH MDG/SGDR
City: Eglin Afb
State: Florida
ZIP Code: 32542-1302
Phone: (850) 883-8785

Specialties & Taxonomy Codes

Specialty	Taxonomy Code	Primary
Student in an Organized Health Care Education/Training Program	390200000X
Dentist	122300000X	Primary

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