Provider Demographics
NPI:1265598528
Name:GARRETT, DEBORAH LYNN (DDS)
Entity type:Individual
Prefix:
First Name:DEBORAH
Middle Name:LYNN
Last Name:GARRETT
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 1:2811 S LOOP 289
Mailing Address - Street 2:UNIT #2
Mailing Address - City:LUBBOCK
Mailing Address - State:TX
Mailing Address - Zip Code:79423-1488
Mailing Address - Country:US
Mailing Address - Phone:806-748-9797
Mailing Address - Fax:
Practice Address - Street 1:2811 S LOOP 289
Practice Address - Street 2:UNIT #2
Practice Address - City:LUBBOCK
Practice Address - State:TX
Practice Address - Zip Code:79423-1488
Practice Address - Country:US
Practice Address - Phone:806-748-9797
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2006-12-29
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX20918122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist