Provider Demographics
NPI:1073862520
Name:PEDRO S. GARCIA DDS., PC
Entity Type:Organization
Organization Name:PEDRO S. GARCIA DDS., PC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:GENERAL
Authorized Official - Prefix:MR
Authorized Official - First Name:PEDRO
Authorized Official - Middle Name:S
Authorized Official - Last Name:GARCIA
Authorized Official - Suffix:
Authorized Official - Credentials:DDS
Authorized Official - Phone:203-931-8885
Mailing Address - Street 1:328 MAIN ST
Mailing Address - Street 2:
Mailing Address - City:WEST HAVEN
Mailing Address - State:CT
Mailing Address - Zip Code:06516-4425
Mailing Address - Country:US
Mailing Address - Phone:203-931-8885
Mailing Address - Fax:203-931-8876
Practice Address - Street 1:328 MAIN ST
Practice Address - Street 2:
Practice Address - City:WEST HAVEN
Practice Address - State:CT
Practice Address - Zip Code:06516-4425
Practice Address - Country:US
Practice Address - Phone:203-931-8885
Practice Address - Fax:203-931-8876
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2012-08-30
Last Update Date:2012-08-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CT081101223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1223G0001XDental ProvidersDentistGeneral PracticeGroup - Single Specialty