Individual
GRACE GARBO
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
DDS
Contact information
Practice address
1808 HIGHWAY 190 W, SUITE D, DERIDDER, LA 70634-6023
(337) 463-6545
(337) 462-3908
Mailing address
1808 HIGHWAY 190 W, SUITE D, DERIDDER, LA 70634-6023
(337) 463-6545
(337) 462-3908
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
4421
LA
Other
Enumeration date
05/24/2007
Last updated
01/12/2016
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