1447345509 NPI number — DANIEL C GARCIA DDS LLC

Table of Contents

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1447345509 NPI number — DANIEL C GARCIA DDS LLC

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
DANIEL C GARCIA DDS LLC
Provider Last Name:
Provider First Name:
Provider Middle Name:
Provider Name Prefix Text:
Provider Name Suffix Text:
Provider Credential Text:
Provider Gender Code:

Provider's Other Name Information

Provider Other Organization Name:
Provider Other Organization Name Type Code:
Provider Other Last Name:
Provider Other First Name:
Provider Other Middle Name:
Provider Other Name Prefix Text:
Provider Other Name Suffix Text:
Provider Other Credential Text:
Provider Other Last Name Type Code:

NPI Number Information

NPI Number:
1447345509
Entity Type Code:
Organization
Replacement NPI:
Last Update Date:
08/22/2020
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
N54W6135 MILL STREET
Provider Second Line Business Mailing Address:
SUITE 900
Provider Business Mailing Address City Name:
CEDARBURY
Provider Business Mailing Address State Name:
WI
Provider Business Mailing Address Postal Code:
53012
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
262-375-8888
Provider Business Mailing Address Fax Number:
262-375-8255

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
N54W6135 MILL ST
Provider Second Line Business Practice Location Address:
SUITE 900
Provider Business Practice Location Address City Name:
CEDARBURG
Provider Business Practice Location Address State Name:
WI
Provider Business Practice Location Address Postal Code:
53012-2021
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
262-375-8888
Provider Business Practice Location Address Fax Number:
262-375-8255
Provider Enumeration Date:
10/04/2006

Additional Information

Authorized Official

Authorized Official Last Name:
GARCIA
Authorized Official First Name:
DANIEL
Authorized Official Middle Name:
C
Authorized Official Title or Position:
MANAGING MEMBER
Authorized Official Telephone Number:
262-375-8888

Provider Taxonomy Codes

  • Taxonomy code: 122300000X ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

Other Provider's Identifiers (legacy, non-NPI)





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