Provider Demographics
NPI:1558465773
Name:GARRISON, DANON (DDS)
Entity Type:Individual
Prefix:DR
First Name:DANON
Middle Name:
Last Name:GARRISON
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 1:6035 BRISTOL PKWY
Mailing Address - Street 2:SUITE #200
Mailing Address - City:CULVER CITY
Mailing Address - State:CA
Mailing Address - Zip Code:90230-6601
Mailing Address - Country:US
Mailing Address - Phone:800-373-5400
Mailing Address - Fax:888-492-2900
Practice Address - Street 1:6035 BRISTOL PKWY
Practice Address - Street 2:SUITE#200
Practice Address - City:CULVER CITY
Practice Address - State:CA
Practice Address - Zip Code:90230-6601
Practice Address - Country:US
Practice Address - Phone:800-373-5400
Practice Address - Fax:888-492-2900
Is Sole Proprietor?:Yes
Enumeration Date:2006-09-08
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA363671223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice