MEDICARE: MS. MARIA CRISTINA GARANZUAY 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	1223G0001X	General Practice Dentistry	22887	TX

General Provider Information

NPI Number	:	1811014061
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MS. MARIA CRISTINA GARANZUAY DDS

Provider Business Mailing Address
First Line	:	4932 WINDSOR HILL
Second Line	:
City	:	SAN ANTONIO
State	:	TX
Zip	:	78239
Country	:	US
Telephone Number	:	210-653-4410
Fax Number	:	210-653-5287

Provider Business Practice Location Address
First Line	:	4932 WINDSOR HL
Second Line	:
City	:	SAN ANTONIO
State	:	TX
Zip	:	78239-2431
Country	:	US
Telephone Number	:	210-653-4410
Fax Number	:	210-653-5287

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	03/23/2007
Last Update Date	:	10/06/2009

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