Provider Demographics
NPI:1740374610
Name:LESNIAK, ROSANNA M (DDS)
Entity type:Individual
Prefix:DR
First Name:ROSANNA
Middle Name:M
Last Name:LESNIAK
Suffix:
Gender:F
Credentials:DDS
Other - Prefix:DR
Other - First Name:ROSE
Other - Middle Name:
Other - Last Name:LESNIAK
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:DDS
Mailing Address - Street 1:4613 W PAYSON CT
Mailing Address - Street 2:
Mailing Address - City:VISALIA
Mailing Address - State:CA
Mailing Address - Zip Code:93291-8250
Mailing Address - Country:US
Mailing Address - Phone:847-770-3605
Mailing Address - Fax:
Practice Address - Street 1:4613 W PAYSON CT
Practice Address - Street 2:
Practice Address - City:VISALIA
Practice Address - State:CA
Practice Address - Zip Code:93291-8250
Practice Address - Country:US
Practice Address - Phone:847-770-3605
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2006-10-03
Last Update Date:2021-08-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA103319122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist