Provider Demographics
NPI:1124233366
Name:ROLAND R. GARCIA D.D.S.
Entity Type:Organization
Organization Name:ROLAND R. GARCIA D.D.S.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:ROLAND
Authorized Official - Middle Name:R
Authorized Official - Last Name:GARCIA
Authorized Official - Suffix:III
Authorized Official - Credentials:DDS
Authorized Official - Phone:210-226-9521
Mailing Address - Street 1:1303 MCCULLOUGH AVE
Mailing Address - Street 2:SUITE 230
Mailing Address - City:SAN ANTONIO
Mailing Address - State:TX
Mailing Address - Zip Code:78212-5609
Mailing Address - Country:US
Mailing Address - Phone:210-226-9521
Mailing Address - Fax:210-226-7853
Practice Address - Street 1:1303 MCCULLOUGH AVE
Practice Address - Street 2:SUITE 230
Practice Address - City:SAN ANTONIO
Practice Address - State:TX
Practice Address - Zip Code:78212-5609
Practice Address - Country:US
Practice Address - Phone:210-226-9521
Practice Address - Fax:210-226-7853
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-05-11
Last Update Date:2017-02-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX149311223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1223G0001XDental ProvidersDentistGeneral PracticeGroup - Single Specialty