Provider Demographics
NPI:1154780534
Name:R. ANDRES GARCIA, DDS, APDC
Entity type:Organization
Organization Name:R. ANDRES GARCIA, DDS, APDC
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:RAUL
Authorized Official - Middle Name:ANDRES
Authorized Official - Last Name:GARCIA
Authorized Official - Suffix:
Authorized Official - Credentials:DDS
Authorized Official - Phone:858-755-7805
Mailing Address - Street 1:12750 CARMEL COUNTRY RD
Mailing Address - Street 2:SUITE 209
Mailing Address - City:SAN DIEGO
Mailing Address - State:CA
Mailing Address - Zip Code:92130-2159
Mailing Address - Country:US
Mailing Address - Phone:858-755-7805
Mailing Address - Fax:
Practice Address - Street 1:12750 CARMEL COUNTRY RD
Practice Address - Street 2:SUITE 209
Practice Address - City:SAN DIEGO
Practice Address - State:CA
Practice Address - Zip Code:92130-2159
Practice Address - Country:US
Practice Address - Phone:858-755-7805
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2016-02-15
Last Update Date:2016-02-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QD0000XAmbulatory Health Care FacilitiesClinic/CenterDental