Provider Demographics
NPI:1609212984
Name:BECERRA GARCIA, MARIA PATRICIA (DDS)
Entity Type:Individual
Prefix:DR
First Name:MARIA
Middle Name:PATRICIA
Last Name:BECERRA GARCIA
Suffix:
Gender:F
Credentials:DDS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:24850 PROSPECT AVE APT F
Mailing Address - Street 2:
Mailing Address - City:LOMA LINDA
Mailing Address - State:CA
Mailing Address - Zip Code:92354-2846
Mailing Address - Country:US
Mailing Address - Phone:561-706-4060
Mailing Address - Fax:
Practice Address - Street 1:24850 PROSPECT AVE APT F
Practice Address - Street 2:
Practice Address - City:LOMA LINDA
Practice Address - State:CA
Practice Address - Zip Code:92354-2846
Practice Address - Country:US
Practice Address - Phone:561-706-4060
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2013-05-14
Last Update Date:2013-05-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX288381223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice