Provider Demographics
NPI:1336278795
Name:GARCIA, NOEMI GISELL (DDS)
Entity Type:Individual
Prefix:DR
First Name:NOEMI
Middle Name:GISELL
Last Name:GARCIA
Suffix:
Gender:F
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:W3377 COUNTY ROAD O
Mailing Address - Street 2:
Mailing Address - City:SHEBOYGAN FALLS
Mailing Address - State:WI
Mailing Address - Zip Code:53085-2211
Mailing Address - Country:US
Mailing Address - Phone:414-460-8575
Mailing Address - Fax:
Practice Address - Street 1:1010 MARITIME DR
Practice Address - Street 2:
Practice Address - City:MANITOWOC
Practice Address - State:WI
Practice Address - Zip Code:54220-2922
Practice Address - Country:US
Practice Address - Phone:920-683-2101
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2007-03-03
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WI60041223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice