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General NPI Number Information
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NPI Number | 1982784401
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Entity Type | Individual
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Provider Name | JOSE ENRIQUE GARCIA D.D.S.
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Gender | Male
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Dates
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Enumeration Date | 10/17/2006
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Last Update Date | 05/04/2010
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Provider Practice Location Address
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Address Line | 1081 TOWN CENTER DR STE 100
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City | ORANGE CITY
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State | FL
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Zip | 32763-8360
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Country | US
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Telephone | 386-456-0097
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Fax | 386-456-0021
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Provider Business Mailing Address
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Address Line | 405 CYPRESS KNEE LN
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City | LAKE MARY
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State | FL
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Zip | 32746-6292
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Country | US
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Telephone | 386-456-0097
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Fax | 385-456-0021
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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 | DN12152
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License Number State | FL
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