Provider Demographics
NPI:1174316954
Name:GARNAND, MARY (RDH)
Entity type:Individual
Prefix:MS
First Name:MARY
Middle Name:
Last Name:GARNAND
Suffix:
Gender:F
Credentials:RDH
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:133 N KANE ST
Mailing Address - Street 2:
Mailing Address - City:BURLINGTON
Mailing Address - State:WI
Mailing Address - Zip Code:53105-1841
Mailing Address - Country:US
Mailing Address - Phone:847-254-0180
Mailing Address - Fax:
Practice Address - Street 1:189 W CHESTNUT ST
Practice Address - Street 2:
Practice Address - City:BURLINGTON
Practice Address - State:WI
Practice Address - Zip Code:53105-1202
Practice Address - Country:US
Practice Address - Phone:847-254-0180
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2025-05-26
Last Update Date:2025-05-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WI1003361-16124Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes124Q00000XDental ProvidersDental Hygienist