Provider Demographics
NPI:1881162063
Name:BLANCA GARCIA
Entity type:Organization
Organization Name:BLANCA GARCIA
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:BLANCA
Authorized Official - Middle Name:KARINA
Authorized Official - Last Name:GARCIA
Authorized Official - Suffix:
Authorized Official - Credentials:DDS
Authorized Official - Phone:915-400-9927
Mailing Address - Street 1:2931 CENTRAL AVE STE 222
Mailing Address - Street 2:
Mailing Address - City:EL PASO
Mailing Address - State:TX
Mailing Address - Zip Code:79905-4101
Mailing Address - Country:US
Mailing Address - Phone:915-400-9927
Mailing Address - Fax:
Practice Address - Street 1:LOPEZ MATEOS 708
Practice Address - Street 2:SUITE 1C
Practice Address - City:JUAREZ
Practice Address - State:CHIHUAHUA
Practice Address - Zip Code:32350
Practice Address - Country:MX
Practice Address - Phone:915-400-9927
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2018-11-06
Last Update Date:2018-11-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
ZZ5864522122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes122300000XDental ProvidersDentistGroup - Single Specialty