Individual
GILLIAN ANN DEGENNARO
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
781 S COTTON LN STE 100, GOODYEAR, AZ 85338-4644
(440) 547-3162
Mailing address
2605 E DATE PALM PASEO APT 2217, ONTARIO, CA 91764-4699
(440) 547-3162
Taxonomy
Speciality
Code
Description
License number
State
122300000X
Dentist
Primary
D011895
AZ
390200000X
Student in an Organized Health Care Education/Training Program
—
—
Other
Enumeration date
04/26/2023
Last updated
07/08/2023
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