Provider Demographics
NPI:1386609691
Name:GARZA, JOHN A (DDS, PC)
Entity type:Individual
Prefix:DR
First Name:JOHN
Middle Name:A
Last Name:GARZA
Suffix:
Gender:M
Credentials:DDS, PC
Other - Prefix:
Other - First Name:JOHN
Other - Middle Name:A
Other - Last Name:GARZA
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:DDS
Mailing Address - Street 1:754 S VAL VISTA DR
Mailing Address - Street 2:#106
Mailing Address - City:GILBERT
Mailing Address - State:AZ
Mailing Address - Zip Code:85296-3157
Mailing Address - Country:US
Mailing Address - Phone:480-539-7979
Mailing Address - Fax:480-539-7977
Practice Address - Street 1:754 S VAL VISTA DR
Practice Address - Street 2:#106
Practice Address - City:GILBERT
Practice Address - State:AZ
Practice Address - Zip Code:85296-3157
Practice Address - Country:US
Practice Address - Phone:480-539-7979
Practice Address - Fax:480-539-7977
Is Sole Proprietor?:Yes
Enumeration Date:2006-04-19
Last Update Date:2007-10-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AZ44811223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice