Provider Demographics
NPI:1881933778
Name:CARLOS F GARCIA DDS INC
Entity type:Organization
Organization Name:CARLOS F GARCIA DDS INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:CARLOS
Authorized Official - Middle Name:FERNANDO
Authorized Official - Last Name:GARCIA
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:949-494-2111
Mailing Address - Street 1:362 3RD ST
Mailing Address - Street 2:SUITE 2
Mailing Address - City:LAGUNA BEACH
Mailing Address - State:CA
Mailing Address - Zip Code:92651-2307
Mailing Address - Country:US
Mailing Address - Phone:949-494-2111
Mailing Address - Fax:
Practice Address - Street 1:362 3RD ST
Practice Address - Street 2:SUITE 2
Practice Address - City:LAGUNA BEACH
Practice Address - State:CA
Practice Address - Zip Code:92651-2307
Practice Address - Country:US
Practice Address - Phone:949-494-2111
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2013-02-12
Last Update Date:2014-11-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAD54413122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes122300000XDental ProvidersDentistGroup - Single Specialty