Provider Demographics
NPI:1801064928
Name:GARBISO DENTAL CARE CENTER
Entity type:Organization
Organization Name:GARBISO DENTAL CARE CENTER
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:REGIONAL MANAGER
Authorized Official - Prefix:
Authorized Official - First Name:JENNIFER
Authorized Official - Middle Name:
Authorized Official - Last Name:GARBISO
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:719-561-2237
Mailing Address - Street 1:3210 WEDGEWOOD DR
Mailing Address - Street 2:
Mailing Address - City:PUEBLO
Mailing Address - State:CO
Mailing Address - Zip Code:81005-2398
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:3210 WEDGEWOOD DR
Practice Address - Street 2:
Practice Address - City:PUEBLO
Practice Address - State:CO
Practice Address - Zip Code:81005-2398
Practice Address - Country:US
Practice Address - Phone:719-561-2237
Practice Address - Fax:719-561-2304
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-02-11
Last Update Date:2008-02-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1223G0001XDental ProvidersDentistGeneral PracticeGroup - Single Specialty