Provider Demographics
NPI:1588812358
Name:GARCIA, ERIC A (DDS)
Entity Type:Individual
Prefix:
First Name:ERIC
Middle Name:A
Last Name:GARCIA
Suffix:
Gender:M
Credentials:DDS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1900 SO ATLANTIC BLVD
Mailing Address - Street 2:SUITE 1
Mailing Address - City:MONTEREY PARK
Mailing Address - State:CA
Mailing Address - Zip Code:91754
Mailing Address - Country:US
Mailing Address - Phone:323-728-6777
Mailing Address - Fax:323-728-6778
Practice Address - Street 1:1900 SO ATLANTIC BLVD
Practice Address - Street 2:SUITE 1
Practice Address - City:MONTEREY PARK
Practice Address - State:CA
Practice Address - Zip Code:91754
Practice Address - Country:US
Practice Address - Phone:323-728-6777
Practice Address - Fax:323-728-6778
Is Sole Proprietor?:Yes
Enumeration Date:2008-09-04
Last Update Date:2008-09-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA21710122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist