Provider Demographics
NPI:1376782003
Name:GARNICA, LORENZO (RDA)
Entity Type:Individual
Prefix:MR
First Name:LORENZO
Middle Name:
Last Name:GARNICA
Suffix:
Gender:M
Credentials:RDA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:14254 HOYT ST
Mailing Address - Street 2:
Mailing Address - City:ARLETA
Mailing Address - State:CA
Mailing Address - Zip Code:91331-5255
Mailing Address - Country:US
Mailing Address - Phone:818-899-2489
Mailing Address - Fax:
Practice Address - Street 1:28237 NEWHALL RANCH RD
Practice Address - Street 2:
Practice Address - City:VALENCIA
Practice Address - State:CA
Practice Address - Zip Code:91355-0986
Practice Address - Country:US
Practice Address - Phone:661-257-4242
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2009-02-19
Last Update Date:2009-02-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA32932126800000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes126800000XDental ProvidersDental Assistant