| Elizabeth Garcia, Dds Prof. Dental Corp. | |
|
4170 Tweedy Blvd South Gate CA 90280-6147 | |
| (323) 564-1745 | |
| (323) 564-1779 |
| Full Name | Elizabeth Garcia, Dds Prof. Dental Corp. |
|---|---|
| Speciality | Dentist |
| Location | 4170 Tweedy Blvd, South Gate, California |
| Authorized Official Name and Position | Elizabeth Garcia (PRESIDENT/DENTIST OWNER) |
| Authorized Official Contact | 3235641745 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Elizabeth Garcia, Dds Prof. Dental Corp. 4170 Tweedy Blvd South Gate CA 90280-6147 Ph: (323) 564-1745 | Elizabeth Garcia, Dds Prof. Dental Corp. 4170 Tweedy Blvd South Gate CA 90280-6147 Ph: (323) 564-1745 |
| NPI Number | 1407179369 |
|---|---|
| Provider Enumeration Date | 03/08/2010 |
| Last Update Date | 03/08/2010 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1407179369 | NPI | - | NPPES |
| B47078 | Medicaid | CA |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 122300000X | Dentist | #47078 (California) | Primary |
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