MEDICARE: GARRETT TOY DDS

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	305R00000X	Preferred Provider Organization	35791	CA

General Provider Information

NPI Number	:	1376095133
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	GARRETT TOY DDS

Provider Business Mailing Address
First Line	:	3615 LAS POSAS RD STE 145
Second Line	:
City	:	CAMARILLO
State	:	CA
Zip	:	93010-1428
Country	:	US
Telephone Number	:	805-484-8363
Fax Number	:	805-484-0583

Provider Business Practice Location Address
First Line	:	3615 LAS POSAS RD STE 145
Second Line	:
City	:	CAMARILLO
State	:	CA
Zip	:	93010-1428
Country	:	US
Telephone Number	:	805-484-8363
Fax Number	:	805-484-0583

Authorized Official
Title or Position	:	OFFICE MANAGER
Name	:	CINDY BYRD
Credential	:
Telephone Number	:	805-484-8363

Provider Enumeration Date	:	10/27/2016
Last Update Date	:	10/27/2016

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