Provider Demographics
NPI:1730317587
Name:GARATE, DAVID MANUEL (DDS)
Entity Type:Individual
Prefix:
First Name:DAVID
Middle Name:MANUEL
Last Name:GARATE
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 1:885 CANARIOS CT STE 210
Mailing Address - Street 2:
Mailing Address - City:CHULA VISTA
Mailing Address - State:CA
Mailing Address - Zip Code:91910-7877
Mailing Address - Country:US
Mailing Address - Phone:619-656-4199
Mailing Address - Fax:619-656-6945
Practice Address - Street 1:885 CANARIOS CT STE 210
Practice Address - Street 2:
Practice Address - City:CHULA VISTA
Practice Address - State:CA
Practice Address - Zip Code:91910-7877
Practice Address - Country:US
Practice Address - Phone:619-656-4199
Practice Address - Fax:619-656-6945
Is Sole Proprietor?:No
Enumeration Date:2009-06-30
Last Update Date:2016-10-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
ZZ111112222122300000X
CA61023122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist