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NPI Code Detail

MEDICARE: DR. ALFREDO GARCIA JR. DDS

MEDICARE: DR. ALFREDO GARCIA JR. DDS
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
11223G0001XGeneral Practice Dentistry7418OK

General Provider Information

NPI Number : 1578130910
Entity Type Code : Individual
Provider Name (Legal Business Name) : DR. ALFREDO GARCIA JR. DDS
Provider Business Mailing Address
First Line : 2828 NW 30TH ST
Second Line :
City : OKLAHOMA CITY
State : OK
Zip : 73112-7404
Country : US
Telephone Number : 405-381-8109
Fax Number :
Provider Business Practice Location Address
First Line : 2828 NW 30TH ST
Second Line :
City : OKLAHOMA CITY
State : OK
Zip : 73112-7404
Country : US
Telephone Number : 405-381-8109
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 06/04/2021
Last Update Date : 06/04/2021

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