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General NPI Number Information
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NPI Number | 1053560946
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Entity Type | Individual
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Provider Name | ERNESTO GARCIA D.D.S.
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Gender | Male
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Dates
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Enumeration Date | 09/16/2008
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Last Update Date | 09/16/2008
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Provider Practice Location Address
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Address Line | 1701 NORTH EL DORADO STREET
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City | STOCKTON
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State | CA
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Zip | 95204-5811
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Country | US
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Telephone | 209-462-2452
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Fax |
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Provider Business Mailing Address
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Address Line | 4125 - 26TH STREET APT. #6
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City | SAN FRANCISCO
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State | CA
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Zip | 94131-1929
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Country | US
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Telephone | 415-641-0917
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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 | 1223G0001X
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Taxonomy Name | General Practice Dentistry
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License Number | 29279
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License Number State | CA
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