Provider Demographics
NPI:1164642112
Name:GARCIA, IDALINA C (DMD, DDS)
Entity Type:Individual
Prefix:DR
First Name:IDALINA
Middle Name:C
Last Name:GARCIA
Suffix:
Gender:F
Credentials:DMD, DDS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:33 WEST HIGGINS ROAD
Mailing Address - Street 2:SUITE 600
Mailing Address - City:SOUTH BARRINGTON
Mailing Address - State:IL
Mailing Address - Zip Code:60010
Mailing Address - Country:US
Mailing Address - Phone:847-426-9000
Mailing Address - Fax:847-426-9050
Practice Address - Street 1:33 WEST HIGGINS ROAD
Practice Address - Street 2:SUITE 600
Practice Address - City:SOUTH BARRINGTON
Practice Address - State:IL
Practice Address - Zip Code:60010
Practice Address - Country:US
Practice Address - Phone:847-426-9000
Practice Address - Fax:847-426-9050
Is Sole Proprietor?:Yes
Enumeration Date:2007-05-01
Last Update Date:2010-05-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL019-0234801223G0001X, 122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice
No122300000XDental ProvidersDentist