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General NPI Number Information
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NPI Number | 1871782458
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Entity Type | Individual
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Provider Name | SARA YSAAC-GARCIA DMD
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Gender | Female
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Dates
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Enumeration Date | 10/18/2007
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Last Update Date | 08/29/2013
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Provider Practice Location Address
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Address Line | 990 STATE ST
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City | NEW HAVEN
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State | CT
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Zip | 06511-3944
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Country | US
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Telephone | 203-787-3669
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Fax |
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Provider Business Mailing Address
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Address Line | 5211 MADISON AVE
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City | TRUMBULL
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State | CT
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Zip | 06611-1040
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Country | US
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Telephone | 203-767-3798
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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 | 1223P0221X
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Taxonomy Name | Pediatric Dentistry
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License Number | 010994
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License Number State | CT
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