Provider Demographics
NPI:1699517425
Name:GARZA ARMENDARIZ, EVANGELINA (DDS)
Entity type:Individual
Prefix:DR
First Name:EVANGELINA
Middle Name:
Last Name:GARZA ARMENDARIZ
Suffix:
Gender:F
Credentials:DDS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1505 W ROBERTS AVE
Mailing Address - Street 2:
Mailing Address - City:FRESNO
Mailing Address - State:CA
Mailing Address - Zip Code:93711-2346
Mailing Address - Country:US
Mailing Address - Phone:915-780-9836
Mailing Address - Fax:
Practice Address - Street 1:1100 N GATEWAY DR
Practice Address - Street 2:
Practice Address - City:MADERA
Practice Address - State:CA
Practice Address - Zip Code:93637-9600
Practice Address - Country:US
Practice Address - Phone:559-363-4160
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2024-06-11
Last Update Date:2024-06-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CADDS1073371223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice