Provider Demographics
NPI:1114191749
Name:GARCIA, ANTHONY GLENN (DDS)
Entity Type:Individual
Prefix:DR
First Name:ANTHONY
Middle Name:GLENN
Last Name:GARCIA
Suffix:
Gender:M
Credentials:DDS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:515 E JOPPA RD
Mailing Address - Street 2:SUITE 200
Mailing Address - City:TOWSON
Mailing Address - State:MD
Mailing Address - Zip Code:21286-5418
Mailing Address - Country:US
Mailing Address - Phone:410-296-4665
Mailing Address - Fax:410-296-3484
Practice Address - Street 1:515 E JOPPA RD
Practice Address - Street 2:SUITE 200
Practice Address - City:TOWSON
Practice Address - State:MD
Practice Address - Zip Code:21286-5418
Practice Address - Country:US
Practice Address - Phone:410-296-4665
Practice Address - Fax:410-296-3484
Is Sole Proprietor?:No
Enumeration Date:2008-04-15
Last Update Date:2008-04-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MD103991223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice