| M Sylvester Gonzales DDS PA | |
|
4010 Sandy Brook Dr. #104 Round Rock TX 78665-1517 | |
| (512) 501-4020 | |
| (512) 501-4020 |
| Full Name | M Sylvester Gonzales DDS PA |
|---|---|
| Speciality | Dentist |
| Location | 4010 Sandy Brook Dr. #104, Round Rock, Texas |
| Authorized Official Name and Position | Manuel Sylvester Gonzales (PRESIDENT) |
| Authorized Official Contact | 5125014020 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| M Sylvester Gonzales DDS PA 4010 Sandy Brook Dr. #104 Round Rock TX 78665-1517 Ph: (512) 501-4020 | M Sylvester Gonzales DDS PA 4010 Sandy Brook Dr. #104 Round Rock TX 78665-1517 Ph: (512) 501-4020 |
| NPI Number | 1194111815 |
|---|---|
| Provider Enumeration Date | 04/09/2015 |
| Last Update Date | 05/21/2015 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1194111815 | NPI | - | NPPES |
| 1053437814 | Other | TX | NPI |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 122300000X | Dentist | 22311 (Texas) | Primary |
| 332BC3200X | Durable Medical Equipment & Medical Supplies - Customized Equipment | 22311 (Texas) | Secondary |
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