Provider Demographics
NPI:1548622988
Name:CARRANZA SANCHEZ, GLORIA LUZ ANGELICA (DDS)
Entity type:Individual
Prefix:MRS
First Name:GLORIA
Middle Name:LUZ ANGELICA
Last Name:CARRANZA SANCHEZ
Suffix:
Gender:F
Credentials:DDS
Other - Prefix:MRS
Other - First Name:GLORIA
Other - Middle Name:LUZ ANGELICA
Other - Last Name:ROCHA
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:
Mailing Address - Street 1:4364 BONITA RD #233
Mailing Address - Street 2:
Mailing Address - City:BONITA
Mailing Address - State:CA
Mailing Address - Zip Code:91902-1421
Mailing Address - Country:US
Mailing Address - Phone:915-383-8069
Mailing Address - Fax:
Practice Address - Street 1:TEPEYAC 2722
Practice Address - Street 2:COL. CORDOBA-AMERICAS
Practice Address - City:CD. JUAREZ
Practice Address - State:CHIHUAHUA
Practice Address - Zip Code:32310
Practice Address - Country:MX
Practice Address - Phone:01152656-611-5252
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2016-03-24
Last Update Date:2016-03-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
ZZ996081122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist