Provider Demographics
NPI:1689380024
Name:GARCIA GARCIA, EDUARDO ENRIQUE (DDS)
Entity Type:Individual
Prefix:
First Name:EDUARDO
Middle Name:ENRIQUE
Last Name:GARCIA 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 1:2874 ROSLYN ST UNIT 4
Mailing Address - Street 2:
Mailing Address - City:DENVER
Mailing Address - State:CO
Mailing Address - Zip Code:80238-2812
Mailing Address - Country:US
Mailing Address - Phone:954-716-2729
Mailing Address - Fax:
Practice Address - Street 1:3955 E EXPOSITION AVE STE 310
Practice Address - Street 2:
Practice Address - City:DENVER
Practice Address - State:CO
Practice Address - Zip Code:80209-5032
Practice Address - Country:US
Practice Address - Phone:303-991-4455
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2023-01-30
Last Update Date:2023-01-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CODEN00205444122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist