Gonzalez Balut, Mauricio
Gonzalez Balut, Mauricio is an sole proprietor health care provider with primary practice located at 159 W Hospitality Ln Ste 100 , San Bernardino CA 92408-3348. He recently has only one registered license in Dental Providers / Orthodontics and Dentofacial Orthopedics, which is considered as his primary health care specialty. Gonzalez Balut, Mauricio can be contacted via phone (909) 558-4960.Contact Information
Primary practice address
159 W Hospitality Ln Ste 100
San Bernardino CA 92408-3348
Phone: (909) 558-4960
Fax:
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Dental Providers / Orthodontics and Dentofacial Orthopedics | 1223X0400X | SP313 | California |
Profile Details
| NPI number | 1770346843 |
|---|---|
| LBN Legal business name | Gonzalez Balut, Mauricio |
| Credentials | DDS, MS |
| Entity | Individual |
| Sole proprietor 1 | Yes |
| Enumeration date | Feb 1st, 2024 |
| Last updated | Feb 1st, 2024 - about 2 years ago |
1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.
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