Hernandez, Gonzalo E
Hernandez, Gonzalo E is an sole proprietor health care provider with primary practice located at 2612 E Calumet St , Appleton WI 54915-4104. He recently has only one registered license in Dental Providers / Pediatric Dentistry, which is considered as his primary health care specialty. Hernandez, Gonzalo E can be contacted via phone (920) 739-6808.Contact Information
Primary practice address
2612 E Calumet St
Appleton WI 54915-4104
Phone: (920) 739-6808
Fax: (920) 730-7353
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Dental Providers / Pediatric Dentistry | 1223P0221X | 4564-015 | Wisconsin |
Profile Details
| NPI number | 1447292537 |
|---|---|
| LBN Legal business name | Hernandez, Gonzalo E |
| Credentials | Doctor of Dental Surgery (DDS) |
| Entity | Individual |
| Sole proprietor 1 | Yes |
| Enumeration date | Jun 12th, 2006 |
| Last updated | Mar 7th, 2023 - about 3 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.
Identifiers
| State | Type | Number | Issuer |
|---|---|---|---|
| All States | NPI | 1447292537 | NPPES |
| Wisconsin | MEDICAID | 33718600 |
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