Provider Demographics
NPI:1891528220
Name:LAROCCA, ISABELLA (DDS)
Entity type:Individual
Prefix:DR
First Name:ISABELLA
Middle Name:
Last Name:LAROCCA
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 1:1580 E DESERT ISLAND DR
Mailing Address - Street 2:
Mailing Address - City:FRESNO
Mailing Address - State:CA
Mailing Address - Zip Code:93730-4521
Mailing Address - Country:US
Mailing Address - Phone:559-824-4768
Mailing Address - Fax:
Practice Address - Street 1:118 N A ST
Practice Address - Street 2:
Practice Address - City:MADERA
Practice Address - State:CA
Practice Address - Zip Code:93638-3210
Practice Address - Country:US
Practice Address - Phone:559-824-4768
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2024-08-21
Last Update Date:2024-08-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA110564122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes122300000XDental ProvidersDentistGroup - Single Specialty