Provider Demographics
NPI:1972727931
Name:GARCIA, LIZA SANTOS (DMD)
Entity Type:Individual
Prefix:
First Name:LIZA
Middle Name:SANTOS
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 1:26837 NAUTICAL LN
Mailing Address - Street 2:
Mailing Address - City:VALENCIA
Mailing Address - State:CA
Mailing Address - Zip Code:91355-1633
Mailing Address - Country:US
Mailing Address - Phone:661-297-9809
Mailing Address - Fax:
Practice Address - Street 1:9700 WOODMAN AVE
Practice Address - Street 2:SUITE A-28
Practice Address - City:ARLETA
Practice Address - State:CA
Practice Address - Zip Code:91331-6459
Practice Address - Country:US
Practice Address - Phone:818-899-9999
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2007-04-12
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA493181223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice