Provider Demographics
NPI:1902155534
Name:GONZALEZ, MICHAEL FRANCO (DDS)
Entity Type:Individual
Prefix:DR
First Name:MICHAEL
Middle Name:FRANCO
Last Name:GONZALEZ
Suffix:
Gender:M
Credentials:DDS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:7544 W NORTH AVE STE 4
Mailing Address - Street 2:
Mailing Address - City:ELMWOOD PARK
Mailing Address - State:IL
Mailing Address - Zip Code:60707-2790
Mailing Address - Country:US
Mailing Address - Phone:708-452-1879
Mailing Address - Fax:708-452-1893
Practice Address - Street 1:7544 W NORTH AVE STE 4
Practice Address - Street 2:
Practice Address - City:ELMWOOD PARK
Practice Address - State:IL
Practice Address - Zip Code:60707-2790
Practice Address - Country:US
Practice Address - Phone:708-452-1879
Practice Address - Fax:708-452-1893
Is Sole Proprietor?:No
Enumeration Date:2012-08-29
Last Update Date:2020-04-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL019029175122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist