Individual
DR. LILLIAN GANDARA
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
DDS
Contact information
Practice address
1904 W PARKSIDE LN, SUITE 201, PHOENIX, AZ 85027-1228
(623) 434-9343
(623) 321-6268
Mailing address
7022 E NELSON DR, TUCSON, AZ 85730-1718
(623) 434-9343
(623) 321-6268
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
20097
TX
1223G0001X
General Practice Dentistry
Primary
D5970
AZ
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
830332
—
AZ
Enumeration date
03/28/2006
Last updated
07/09/2007
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