Provider Demographics
NPI:1295730950
Name:GIROD, TERESA E CANZONERI (DDS)
Entity type:Individual
Prefix:DR
First Name:TERESA
Middle Name:E CANZONERI
Last Name:GIROD
Suffix:
Gender:F
Credentials:DDS
Other - Prefix:DR
Other - First Name:TERESA
Other - Middle Name:ELIZABETH
Other - Last Name:CANZONERI
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:DDS
Mailing Address - Street 1:1595 CORNERSTONE CT STE B
Mailing Address - Street 2:
Mailing Address - City:BEAUMONT
Mailing Address - State:TX
Mailing Address - Zip Code:77706-4066
Mailing Address - Country:US
Mailing Address - Phone:409-898-0178
Mailing Address - Fax:
Practice Address - Street 1:590 DOWLEN RD
Practice Address - Street 2:
Practice Address - City:BEAUMONT
Practice Address - State:TX
Practice Address - Zip Code:77706-6014
Practice Address - Country:US
Practice Address - Phone:409-866-9541
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2005-06-17
Last Update Date:2023-06-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX19939122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist