MEDICARE: TRG DENTAL ASSOCIATES

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	1223G0001X	General Practice Dentistry	21522	TX

General Provider Information

NPI Number	:	1275764383
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	TRG DENTAL ASSOCIATES

Provider Business Mailing Address
First Line	:	6801 S I H 35
Second Line	:	SUITE 1-D
City	:	AUSTIN
State	:	TX
Zip	:	78744-4824
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	6801 S I H 35
Second Line	:	SUITE 1-D
City	:	AUSTIN
State	:	TX
Zip	:	78744-4824
Country	:	US
Telephone Number	:	512-507-3771
Fax Number	:

Authorized Official
Title or Position	:	OWNER
Name	:	DR. TODD R. GARCIA
Credential	:	DDS
Telephone Number	:	512-507-3771

Provider Enumeration Date	:	08/06/2009
Last Update Date	:	08/06/2009

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Directions to “TRG DENTAL ASSOCIATES ” Practice Location

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