Provider Demographics
NPI:1235796954
Name:GARCIA, CAROLINA (DMD)
Entity Type:Individual
Prefix:
First Name:CAROLINA
Middle Name:
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 1:8150 POINT MEADOWS DR APT 1712
Mailing Address - Street 2:
Mailing Address - City:JACKSONVILLE
Mailing Address - State:FL
Mailing Address - Zip Code:32256-0610
Mailing Address - Country:US
Mailing Address - Phone:786-376-9922
Mailing Address - Fax:
Practice Address - Street 1:14866 OLD SAINT AUGUSTINE RD STE 111
Practice Address - Street 2:
Practice Address - City:JACKSONVILLE
Practice Address - State:FL
Practice Address - Zip Code:32258-2611
Practice Address - Country:US
Practice Address - Phone:904-342-6222
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2019-05-29
Last Update Date:2021-11-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLDN24116122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist