Provider Demographics
NPI:1003549429
Name:AMAYA GARCIA, GRACIA MARIA (DMD)
Entity Type:Individual
Prefix:DR
First Name:GRACIA
Middle Name:MARIA
Last Name:AMAYA GARCIA
Suffix:
Gender:F
Credentials:DMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:917 HARRISON AVE
Mailing Address - Street 2:
Mailing Address - City:MURFREESBORO
Mailing Address - State:TN
Mailing Address - Zip Code:37130-2608
Mailing Address - Country:US
Mailing Address - Phone:615-498-2260
Mailing Address - Fax:
Practice Address - Street 1:1513 N JACKSON ST
Practice Address - Street 2:
Practice Address - City:TULLAHOMA
Practice Address - State:TN
Practice Address - Zip Code:37388-2343
Practice Address - Country:US
Practice Address - Phone:615-498-2260
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2022-07-04
Last Update Date:2022-07-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TN11929122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist