Provider Demographics
NPI:1154683050
Name:GARCIA, JEFFREY JOSEPH (DDS)
Entity Type:Individual
Prefix:DR
First Name:JEFFREY
Middle Name:JOSEPH
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 1:560 RUGH ST
Mailing Address - Street 2:SUITE 100
Mailing Address - City:GREENSBURG
Mailing Address - State:PA
Mailing Address - Zip Code:15601-5601
Mailing Address - Country:US
Mailing Address - Phone:878-295-8322
Mailing Address - Fax:
Practice Address - Street 1:560 RUGH ST
Practice Address - Street 2:SUITE 100
Practice Address - City:GREENSBURG
Practice Address - State:PA
Practice Address - Zip Code:15601-5601
Practice Address - Country:US
Practice Address - Phone:878-295-8322
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2012-06-15
Last Update Date:2016-09-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PADS0406671223S0112X, 1223S0112X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223S0112XDental ProvidersDentistOral and Maxillofacial Surgery