Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 1223P0221X | Pediatric Dentist | 2547 | PR |
NPI | 1073711131 |
---|---|
Provider Name | Yadira Garcia |
First Address | Arecibo, PR 00614-1557 |
Second Address | Arecibo, PR 00612-9539 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 10/07/2007 |
Last Update Date | 10/07/2007 |