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NPI 1124233366

NPI 1124233366 : ROLAND R. GARCIA D.D.S. : SAN ANTONIO, TX

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General NPI Number Information
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    NPI Number           |    1124233366
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    Entity Type          |    Organization 
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    Legal Business Name  |    ROLAND R. GARCIA D.D.S. 
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Dates
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    Enumeration Date     |    05/11/2007
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    Last Update Date     |    02/22/2017
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Provider Practice Location Address
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    Address Line         |    1303 MCCULLOUGH AVE SUITE 230
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    City                 |    SAN ANTONIO
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    State                |    TX
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    Zip                  |    78212-5609
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    Country              |    US
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    Telephone            |    210-226-9521
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    Fax                  |    210-226-7853
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Provider Business Mailing Address
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    Address Line         |    1303 MCCULLOUGH AVE SUITE 230
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    City                 |    SAN ANTONIO
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    State                |    TX
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    Zip                  |    78212-5609
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    Country              |    US
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    Telephone            |    210-226-9521
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    Fax                  |    210-226-7853
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Authorized Official
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    Title or Position    |    PRESIDENT
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    Name                 |    DR. ROLAND R. GARCIA III
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    Credential           |    D.D.S.
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    Telephone            |    210-226-9521
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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       |    14931
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    License Number State |    TX
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