Provider Demographics
NPI:1518350842
Name:GARCIA, CAROLINE S (DDS, MD)
Entity Type:Individual
Prefix:
First Name:CAROLINE
Middle Name:S
Last Name:GARCIA
Suffix:
Gender:F
Credentials:DDS, MD
Other - Prefix:
Other - First Name:CAROLINE
Other - Middle Name:R
Other - Last Name:SIKES
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:DDS, MD
Mailing Address - Street 1:6912 FERN LOOP STE A
Mailing Address - Street 2:
Mailing Address - City:SHREVEPORT
Mailing Address - State:LA
Mailing Address - Zip Code:71105-4176
Mailing Address - Country:US
Mailing Address - Phone:318-585-7667
Mailing Address - Fax:318-585-6912
Practice Address - Street 1:6912 FERN LOOP STE A
Practice Address - Street 2:
Practice Address - City:SHREVEPORT
Practice Address - State:LA
Practice Address - Zip Code:71105-4176
Practice Address - Country:US
Practice Address - Phone:318-585-7667
Practice Address - Fax:318-585-6912
Is Sole Proprietor?:No
Enumeration Date:2015-03-11
Last Update Date:2024-01-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
LA65731223S0112X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223S0112XDental ProvidersDentistOral and Maxillofacial Surgery