Provider Demographics
NPI:1679690051
Name:GARCIA, JAVIER (DMD)
Entity Type:Individual
Prefix:DR
First Name:JAVIER
Middle Name:
Last Name:GARCIA
Suffix:
Gender:M
Credentials:DMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:E6 CALLE 1
Mailing Address - Street 2:URB RIVERSIDE PARK
Mailing Address - City:BAYAMON
Mailing Address - State:PR
Mailing Address - Zip Code:00961-8594
Mailing Address - Country:US
Mailing Address - Phone:787-798-4800
Mailing Address - Fax:787-780-4222
Practice Address - Street 1:ALTURAS DE FLAMBOYAN
Practice Address - Street 2:N60 TNTE MARTINEZ AVE
Practice Address - City:BAYAMON
Practice Address - State:PR
Practice Address - Zip Code:00959-8103
Practice Address - Country:US
Practice Address - Phone:787-798-4800
Practice Address - Fax:787-780-4222
Is Sole Proprietor?:Yes
Enumeration Date:2007-03-23
Last Update Date:2012-11-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PR16241223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice