Provider Demographics
NPI:1033724794
Name:GARCIA VELAZCO, ANA
Entity Type:Individual
Prefix:
First Name:ANA
Middle Name:
Last Name:GARCIA VELAZCO
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:450 GIBNER RD STE 2
Mailing Address - Street 2:
Mailing Address - City:CARLISLE
Mailing Address - State:PA
Mailing Address - Zip Code:17013-5095
Mailing Address - Country:US
Mailing Address - Phone:717-245-4542
Mailing Address - Fax:
Practice Address - Street 1:450 GIBNER RD STE 2
Practice Address - Street 2:
Practice Address - City:CARLISLE
Practice Address - State:PA
Practice Address - Zip Code:17013-5095
Practice Address - Country:US
Practice Address - Phone:717-245-4542
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2020-09-10
Last Update Date:2020-09-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes124Q00000XDental ProvidersDental Hygienist