Provider Demographics
NPI:1073966933
Name:GARCIA, MARIA SALUD (DMD)
Entity Type:Individual
Prefix:MRS
First Name:MARIA
Middle Name:SALUD
Last Name: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 1:10712 1/2 POPLAR ST
Mailing Address - Street 2:
Mailing Address - City:LOMA LINDA
Mailing Address - State:CA
Mailing Address - Zip Code:92354-2204
Mailing Address - Country:US
Mailing Address - Phone:619-829-5166
Mailing Address - Fax:
Practice Address - Street 1:10712 1/2 POPLAR ST
Practice Address - Street 2:
Practice Address - City:LOMA LINDA
Practice Address - State:CA
Practice Address - Zip Code:92354-2204
Practice Address - Country:US
Practice Address - Phone:619-829-5166
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2016-07-15
Last Update Date:2016-07-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA1004361223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice