Provider Demographics
NPI:1528232972
Name:CLINICA DENTAL DR. GARCIA JORDAN PSC
Entity Type:Organization
Organization Name:CLINICA DENTAL DR. GARCIA JORDAN PSC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:HANS
Authorized Official - Middle Name:G
Authorized Official - Last Name:GARCIA
Authorized Official - Suffix:
Authorized Official - Credentials:D
Authorized Official - Phone:787-795-0320
Mailing Address - Street 1:AVE AMALIA PAOLI HP 13
Mailing Address - Street 2:LEVITTOWN
Mailing Address - City:TOA BAJA
Mailing Address - State:PR
Mailing Address - Zip Code:00949
Mailing Address - Country:US
Mailing Address - Phone:787-795-0320
Mailing Address - Fax:787-261-7295
Practice Address - Street 1:AVE AMALIA PAOLI HP 13
Practice Address - Street 2:LEVITTOWN
Practice Address - City:TOA BAJA
Practice Address - State:PR
Practice Address - Zip Code:00949
Practice Address - Country:US
Practice Address - Phone:787-795-0320
Practice Address - Fax:787-261-7295
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-04-16
Last Update Date:2008-04-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes122300000XDental ProvidersDentistGroup - Single Specialty