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Provider Information for 1780893222



DR. ROGER LEE GARRETT DDS

Gender: MALE

Individual NPI: 1780893222

Calendar Last Updated: 2007-07-08

Details

Name Value
NPI 1780893222
Enumeration Date 2007-05-22
NPI Type 1 - Individual
Sole Proprietor NO
Status Active
Mailing Address 104 SATINWOOD AVE
OAK PARK, CA 91377-1244
United States

Phone: 818-991-5182 | Fax: 818-991-8863
View Map External Link
Primary Practice Address 23695 CALABASAS RD
CALABASAS, CA 91302-1502
United States

Phone: 818-591-2480 | Fax: 818-591-7599
View Map External Link
Health Information Exchange
Endpoint Type Endpoint Endpoint Description Use Content Type Affiliation Endpoint Location
Other Identifiers
Issuer State Number
Taxonomy
Primary Taxonomy Selected Taxonomy State License Number
Yes 1223G0001X - Dentist General Practice CA 28443