Provider Demographics
NPI:1366870297
Name:DE GREGORIO GONZALEZ, CESAR (DDS, MSD)
Entity type:Individual
Prefix:
First Name:CESAR
Middle Name:
Last Name:DE GREGORIO GONZALEZ
Suffix:
Gender:M
Credentials:DDS, MSD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1959 NE PACIFIC ST
Mailing Address - Street 2:D-669 HEALTH SCIENCE CENTER BOX 357448
Mailing Address - City:SEATTLE
Mailing Address - State:WA
Mailing Address - Zip Code:98195-7448
Mailing Address - Country:US
Mailing Address - Phone:206-616-1758
Mailing Address - Fax:
Practice Address - Street 1:1959 NE PACIFIC ST
Practice Address - Street 2:D-669 HEALTH SCIENCE CENTER BOX 357448
Practice Address - City:SEATTLE
Practice Address - State:WA
Practice Address - Zip Code:98195-7448
Practice Address - Country:US
Practice Address - Phone:206-616-1758
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2013-11-01
Last Update Date:2014-03-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WADF604145911223E0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223E0200XDental ProvidersDentistEndodontics