Provider Demographics
NPI:1184614273
Name:GARCIA, ROXANNA C (DDS)
Entity type:Individual
Prefix:DR
First Name:ROXANNA
Middle Name:C
Last Name:GARCIA
Suffix:
Gender:F
Credentials:DDS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1306 W KIWI AVENUE APARTMENT #3
Mailing Address - Street 2:
Mailing Address - City:PHARR
Mailing Address - State:TX
Mailing Address - Zip Code:78577
Mailing Address - Country:US
Mailing Address - Phone:407-359-8415
Mailing Address - Fax:407-359-8415
Practice Address - Street 1:921 E MAIN AVENUE
Practice Address - Street 2:SUITE 2
Practice Address - City:ALTON
Practice Address - State:TX
Practice Address - Zip Code:78573
Practice Address - Country:US
Practice Address - Phone:407-678-3330
Practice Address - Fax:956-583-5067
Is Sole Proprietor?:No
Enumeration Date:2005-10-28
Last Update Date:2021-05-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX28281122300000X, 1223G0001X
FLDN166291223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice
No122300000XDental ProvidersDentist