Provider Demographics
NPI:1073163663
Name:THERESA GARCIA STEHURA D D S INC
Entity Type:Organization
Organization Name:THERESA GARCIA STEHURA D D S INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:THERESA
Authorized Official - Middle Name:
Authorized Official - Last Name:STEHURA
Authorized Official - Suffix:
Authorized Official - Credentials:DDS
Authorized Official - Phone:323-664-7742
Mailing Address - Street 1:1824 HYPERION AVE
Mailing Address - Street 2:
Mailing Address - City:LOS ANGELES
Mailing Address - State:CA
Mailing Address - Zip Code:90027-4738
Mailing Address - Country:US
Mailing Address - Phone:323-664-7742
Mailing Address - Fax:
Practice Address - Street 1:1824 HYPERION AVE
Practice Address - Street 2:
Practice Address - City:LOS ANGELES
Practice Address - State:CA
Practice Address - Zip Code:90027-4738
Practice Address - Country:US
Practice Address - Phone:323-664-7742
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2019-09-16
Last Update Date:2019-09-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1223S0112XDental ProvidersDentistOral and Maxillofacial SurgeryGroup - Single Specialty