Provider Demographics
NPI:1508479437
Name:GADIA, ROCELLE PAULINE MARIE (DDS)
Entity Type:Individual
Prefix:
First Name:ROCELLE PAULINE
Middle Name:MARIE
Last Name:GADIA
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 1:2600 SHASTA AVE
Mailing Address - Street 2:
Mailing Address - City:MCALLEN
Mailing Address - State:TX
Mailing Address - Zip Code:78504-4774
Mailing Address - Country:US
Mailing Address - Phone:832-779-7305
Mailing Address - Fax:
Practice Address - Street 1:930 E EXPRESSWAY 83
Practice Address - Street 2:
Practice Address - City:MCALLEN
Practice Address - State:TX
Practice Address - Zip Code:78503-1613
Practice Address - Country:US
Practice Address - Phone:956-540-7825
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2020-08-29
Last Update Date:2021-11-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX365921223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice