MEDICARE: DR. MILDRED NICOLE GARCIA 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
1	122300000X	Dentist	38510	TX

General Provider Information

NPI Number	:	1730819483
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. MILDRED NICOLE GARCIA DDS

Provider Business Mailing Address
First Line	:	1749 DELAFORD DR
Second Line	:
City	:	CARROLLTON
State	:	TX
Zip	:	75007-3030
Country	:	US
Telephone Number	:	972-375-1792
Fax Number	:

Provider Business Practice Location Address
First Line	:	1300 S LOOP 288 STE 100
Second Line	:
City	:	DENTON
State	:	TX
Zip	:	76205-4607
Country	:	US
Telephone Number	:	940-484-4313
Fax Number	:

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

Provider Enumeration Date	:	06/15/2022
Last Update Date	:	06/15/2022

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