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General NPI Number Information
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NPI Number | 1881933778
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Entity Type | Organization
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Legal Business Name | CARLOS F GARCIA DDS INC
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Dates
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Enumeration Date | 02/12/2013
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Last Update Date | 11/21/2014
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Provider Practice Location Address
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Address Line | 362 3RD ST SUITE 2
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City | LAGUNA BEACH
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State | CA
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Zip | 92651-2307
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Country | US
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Telephone | 949-494-2111
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Fax |
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Provider Business Mailing Address
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Address Line | 362 3RD ST SUITE 2
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City | LAGUNA BEACH
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State | CA
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Zip | 92651-2307
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Country | US
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Telephone | 949-494-2111
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Fax |
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Authorized Official
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Title or Position | OWNER
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Name | DR. CARLOS FERNANDO GARCIA
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Credential |
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Telephone | 949-494-2111
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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 | D54413
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License Number State | CA
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