Provider Demographics
NPI:1598858805
Name:GARCIA, JUAN M (DDS)
Entity Type:Individual
Prefix:DR
First Name:JUAN
Middle Name:M
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 1:432 SOUTH DR
Mailing Address - Street 2:
Mailing Address - City:MIAMI SPRINGS
Mailing Address - State:FL
Mailing Address - Zip Code:33166-5946
Mailing Address - Country:US
Mailing Address - Phone:305-821-2261
Mailing Address - Fax:305-819-8570
Practice Address - Street 1:1490 W 49TH PL STE 450
Practice Address - Street 2:
Practice Address - City:HIALEAH
Practice Address - State:FL
Practice Address - Zip Code:33012-3196
Practice Address - Country:US
Practice Address - Phone:305-821-2261
Practice Address - Fax:305-819-8570
Is Sole Proprietor?:Yes
Enumeration Date:2006-10-02
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLDN00118151223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice