MEDICARE: DR. ADOLPH C GARZA D.D.S.

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	1223G0001X	General Practice Dentistry	DEN5692	DC

General Provider Information

NPI Number	:	1205838695
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. ADOLPH C GARZA D.D.S.

Provider Business Mailing Address
First Line	:	NAVAL MEDICAL CENTER SAN DIEGO
Second Line	:	34800 BOB WILSON DRIVE
City	:	SAN DIEGO
State	:	CA
Zip	:	92134-0001
Country	:	US
Telephone Number	:	619-876-1587
Fax Number	:

Provider Business Practice Location Address
First Line	:	NAVAL MEDICAL CENTER SAN DIEGO
Second Line	:	34800 BOB WILSON DRIVE
City	:	SAN DIEGO
State	:	CA
Zip	:	92134-0001
Country	:	US
Telephone Number	:	619-876-1587
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	08/15/2005
Last Update Date	:	05/29/2014

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