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General NPI Number Information
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NPI Number | 1578920526
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Entity Type | Individual
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Provider Name | MATTHEW GARCIA D.M.D
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Gender | Male
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Dates
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Enumeration Date | 01/21/2016
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Last Update Date | 06/14/2016
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Provider Practice Location Address
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Address Line | 351 WEST 6TH STREET, BLDG 440 U.S. ARMY DENTAL ACTIVITY, DENTAL CLINIC #1
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City | FORT STEWART
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State | GA
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Zip | 31314-4704
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Country | US
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Telephone | 912-435-7009
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Fax |
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Provider Business Mailing Address
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Address Line | 1061 HARMON AVE BLDG 357
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City | FORT STEWART
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State | GA
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Zip | 31314-5641
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Country | US
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Telephone |
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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 | DS040687
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License Number State | PA
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