Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 124Q00000X | Dental Hygienist | DH2807 | NM |
NPI | 1033421086 |
---|---|
Provider Name | Sharla Garcia |
First Address | Bernalillo, NM 87004-5380 |
Second Address | Zia Pueblo, NM 87053-6013 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 07/07/2010 |
Last Update Date | 07/07/2010 |