Provider Demographics
NPI:1871782458
Name:YSAAC-GARCIA, SARA (DMD)
Entity type:Individual
Prefix:DR
First Name:SARA
Middle Name:
Last Name:YSAAC-GARCIA
Suffix:
Gender:F
Credentials:DMD
Other - Prefix:
Other - First Name:SARA
Other - Middle Name:
Other - Last Name:YSAAC
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:DMD
Mailing Address - Street 1:5211 MADISON AVE
Mailing Address - Street 2:
Mailing Address - City:TRUMBULL
Mailing Address - State:CT
Mailing Address - Zip Code:06611-1040
Mailing Address - Country:US
Mailing Address - Phone:203-767-3798
Mailing Address - Fax:
Practice Address - Street 1:990 STATE ST
Practice Address - Street 2:
Practice Address - City:NEW HAVEN
Practice Address - State:CT
Practice Address - Zip Code:06511-3944
Practice Address - Country:US
Practice Address - Phone:203-787-3669
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2007-10-18
Last Update Date:2013-08-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CT0109941223P0221X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223P0221XDental ProvidersDentistPediatric Dentistry