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General NPI Number Information
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NPI Number | 1003549429
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Entity Type | Individual
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Provider Name | GRACIA MARIA AMAYA GARCIA DMD
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Gender | Female
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Dates
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Enumeration Date | 07/04/2022
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Last Update Date | 07/05/2022
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Provider Practice Location Address
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Address Line | 1513 N JACKSON ST
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City | TULLAHOMA
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State | TN
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Zip | 37388-2343
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Country | US
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Telephone | 615-498-2260
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Fax |
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Provider Business Mailing Address
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Address Line | 917 HARRISON AVE
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City | MURFREESBORO
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State | TN
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Zip | 37130-2608
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Country | US
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Telephone | 615-498-2260
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 122300000X
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Taxonomy Name | Dentist
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License Number | 11929
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License Number State | TN
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