Provider Demographics
NPI:1982615761
Name:GARZA, ROSANNE (DDS)
Entity Type:Individual
Prefix:MS
First Name:ROSANNE
Middle Name:
Last Name:GARZA
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 1:844 N CLINE AVE
Mailing Address - Street 2:
Mailing Address - City:GRIFFITH
Mailing Address - State:IN
Mailing Address - Zip Code:46319-1504
Mailing Address - Country:US
Mailing Address - Phone:219-924-3213
Mailing Address - Fax:219-924-7764
Practice Address - Street 1:844 N CLINE AVE
Practice Address - Street 2:
Practice Address - City:GRIFFITH
Practice Address - State:IN
Practice Address - Zip Code:46319-1504
Practice Address - Country:US
Practice Address - Phone:219-924-3213
Practice Address - Fax:219-924-7764
Is Sole Proprietor?:Yes
Enumeration Date:2006-08-10
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IN120091181223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice