Provider Demographics
NPI:1275854036
Name:GARNIER, KANGNA NOU (DDS)
Entity Type:Individual
Prefix:DR
First Name:KANGNA
Middle Name:NOU
Last Name:GARNIER
Suffix:
Gender:F
Credentials:DDS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:10151 ARROW RTE
Mailing Address - Street 2:APT. 48
Mailing Address - City:RANCHO CUCAMONGA
Mailing Address - State:CA
Mailing Address - Zip Code:91730-4765
Mailing Address - Country:US
Mailing Address - Phone:909-418-1966
Mailing Address - Fax:
Practice Address - Street 1:13197 CENTRAL AVE
Practice Address - Street 2:SUITE 103
Practice Address - City:CHINO
Practice Address - State:CA
Practice Address - Zip Code:91710-4178
Practice Address - Country:US
Practice Address - Phone:909-627-8501
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2010-06-16
Last Update Date:2010-06-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA589021223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice