Provider Demographics
NPI:1700923851
Name:GARLAND, DIANNE T (DMD)
Entity type:Individual
Prefix:DR
First Name:DIANNE
Middle Name:T
Last Name:GARLAND
Suffix:
Gender:F
Credentials:DMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:HACIENDA SAN JOSE SJ1
Mailing Address - Street 2:ST. #1
Mailing Address - City:CAGUAS
Mailing Address - State:PR
Mailing Address - Zip Code:00727
Mailing Address - Country:US
Mailing Address - Phone:939-940-9553
Mailing Address - Fax:
Practice Address - Street 1:HACIENDA SAN JOSE SJ1
Practice Address - Street 2:CALLE MIRASOLES
Practice Address - City:CAGUAS
Practice Address - State:PR
Practice Address - Zip Code:00727
Practice Address - Country:US
Practice Address - Phone:939-940-9553
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-01-30
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PR2445122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist