Provider Demographics
NPI:1568586618
Name:S. J. GARZA, D.D.S. INC.
Entity Type:Organization
Organization Name:S. J. GARZA, D.D.S. INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:SAN JUAN
Authorized Official - Middle Name:
Authorized Official - Last Name:GARZA
Authorized Official - Suffix:
Authorized Official - Credentials:DDS
Authorized Official - Phone:559-439-7755
Mailing Address - Street 1:7472 N FRESNO ST
Mailing Address - Street 2:SUITE 201
Mailing Address - City:FRESNO
Mailing Address - State:CA
Mailing Address - Zip Code:93720-2459
Mailing Address - Country:US
Mailing Address - Phone:559-439-7755
Mailing Address - Fax:559-439-6555
Practice Address - Street 1:7472 N FRESNO ST
Practice Address - Street 2:SUITE 201
Practice Address - City:FRESNO
Practice Address - State:CA
Practice Address - Zip Code:93720-2459
Practice Address - Country:US
Practice Address - Phone:559-439-7755
Practice Address - Fax:559-439-6555
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-03-16
Last Update Date:2011-11-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA25800122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes122300000XDental ProvidersDentistGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
CA25800OtherLICENSE NUMBER