Provider Demographics
NPI:1437780442
Name:HIRAM A GARCIA DENTAL IMPLANTS AND ORAL SURGERY PLLC
Entity Type:Organization
Organization Name:HIRAM A GARCIA DENTAL IMPLANTS AND ORAL SURGERY PLLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:HIRAM
Authorized Official - Middle Name:AMADO
Authorized Official - Last Name:GARCIA-RIVERA
Authorized Official - Suffix:
Authorized Official - Credentials:DMD
Authorized Official - Phone:818-462-1703
Mailing Address - Street 1:PO BOX 49
Mailing Address - Street 2:
Mailing Address - City:WATERTOWN
Mailing Address - State:NY
Mailing Address - Zip Code:13601-0049
Mailing Address - Country:US
Mailing Address - Phone:818-462-1703
Mailing Address - Fax:
Practice Address - Street 1:19472 US ROUTE 11
Practice Address - Street 2:
Practice Address - City:WATERTOWN
Practice Address - State:NY
Practice Address - Zip Code:13601-5387
Practice Address - Country:US
Practice Address - Phone:818-462-1703
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2020-01-29
Last Update Date:2020-01-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1223S0112XDental ProvidersDentistOral and Maxillofacial SurgeryGroup - Single Specialty