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General NPI Number Information
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NPI Number | 1134979727
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Entity Type | Organization
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Legal Business Name | 956 DENTAL
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Dates
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Enumeration Date | 03/25/2024
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Last Update Date | 04/28/2024
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Provider Practice Location Address
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Address Line | 3311 E DEL MAR BLVD STE 102
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City | LAREDO
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State | TX
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Zip | 78041-2449
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Country | US
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Telephone | 956-508-2480
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Fax |
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Provider Business Mailing Address
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Address Line | 7550 COUNTRY CLUB DR APT 10104
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City | LAREDO
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State | TX
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Zip | 78041-3252
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Country | US
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Telephone | 956-286-5674
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Fax |
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Authorized Official
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Title or Position | SOLE OWNER
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Name | DR. LOUIS ALFONSO GARCIA SR.
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Credential | DDS
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Telephone | 956-286-5674
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261QD0000X
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Taxonomy Name | Dental Clinic/Center
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License Number |
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License Number State |
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