Provider Demographics
NPI:1912955477
Name:GARCIA, IRINEO G (DDS)
Entity Type:Individual
Prefix:DR
First Name:IRINEO
Middle Name:G
Last Name:GARCIA
Suffix:
Gender:M
Credentials:DDS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1350 E EDINGER AVE
Mailing Address - Street 2:
Mailing Address - City:SANTA ANA
Mailing Address - State:CA
Mailing Address - Zip Code:92705-4419
Mailing Address - Country:US
Mailing Address - Phone:714-667-6013
Mailing Address - Fax:714-667-8160
Practice Address - Street 1:1350 E EDINGER AVE
Practice Address - Street 2:
Practice Address - City:SANTA ANA
Practice Address - State:CA
Practice Address - Zip Code:92705-4419
Practice Address - Country:US
Practice Address - Phone:714-667-6013
Practice Address - Fax:714-667-8160
Is Sole Proprietor?:Not Answered
Enumeration Date:2006-05-05
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA363661223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice