Provider Demographics
NPI:1750460390
Name:GARCIA, ISABEL (DDS)
Entity type:Individual
Prefix:DR
First Name:ISABEL
Middle Name:
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 1:116B RIVER RD
Mailing Address - Street 2:
Mailing Address - City:BOGOTA
Mailing Address - State:NJ
Mailing Address - Zip Code:07603-1509
Mailing Address - Country:US
Mailing Address - Phone:201-637-1424
Mailing Address - Fax:
Practice Address - Street 1:423 E 138TH ST
Practice Address - Street 2:2ND FLOOR
Practice Address - City:BRONX
Practice Address - State:NY
Practice Address - Zip Code:10454-3004
Practice Address - Country:US
Practice Address - Phone:718-292-3800
Practice Address - Fax:718-292-3803
Is Sole Proprietor?:No
Enumeration Date:2006-11-03
Last Update Date:2007-09-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY0506761223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY02410662Medicaid