# DR. JEANNE ANTOINETTE DEGRAZIA

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- **Entity:** Individual
- **Status:** Active
- **Sole proprietor:** No

## Provider details

- **NPI number:** 1003092305
- **Gender:** F
- **Credential:** D.D.S.

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 1223G0001X | General Practice Dentistry | 12009463A | IN | Yes |

## Other

- **Enumeration date:** 01/16/2008
- **Last updated:** 01/16/2008

## Other identifiers

| Code | Description | Identifier | Issuer | State |
| --- | --- | --- | --- | --- |
| 05 | — | 200534070 | — | IN |