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General NPI Number Information
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NPI Number | 1962224683
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Entity Type | Individual
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Provider Name | JACOB I GARCIA DDS
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Gender | Male
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Dates
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Enumeration Date | 10/25/2024
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Last Update Date | 01/09/2025
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Provider Practice Location Address
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Address Line | 1105 MEMORIAL DR
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City | ARTESIA
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State | NM
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Zip | 88210-1189
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Country | US
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Telephone | 505-617-0990
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Fax |
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Provider Business Mailing Address
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Address Line | 1105 MEMORIAL DR
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City | ARTESIA
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State | NM
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Zip | 88210-1189
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Country | US
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Telephone | 575-746-9848
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Fax | 505-443-8317
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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 | 1223G0001X
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Taxonomy Name | General Practice Dentistry
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License Number | DB-2024-0372
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License Number State | NM
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