Provider Demographics
NPI:1760548903
Name:GARCIA, LIZMARY (DMD)
Entity Type:Individual
Prefix:DR
First Name:LIZMARY
Middle Name:
Last Name:GARCIA
Suffix:
Gender:F
Credentials:DMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:200 CALLE ALCALA #1702 B
Mailing Address - Street 2:COLLEGE PARK APARTMENTS
Mailing Address - City:SAN JUAN
Mailing Address - State:PR
Mailing Address - Zip Code:00921-3910
Mailing Address - Country:US
Mailing Address - Phone:787-381-4905
Mailing Address - Fax:
Practice Address - Street 1:Z-30 AVE. LAUREL
Practice Address - Street 2:URB. LOMAS VERDES
Practice Address - City:BAYAMON
Practice Address - State:PR
Practice Address - Zip Code:00956
Practice Address - Country:US
Practice Address - Phone:787-787-2384
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2006-12-30
Last Update Date:2014-10-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PR0027501223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice