Provider Demographics
NPI:1053643908
Name:CEDACERO, ZOILA M (DENTAL HYGIENIST)
Entity Type:Individual
Prefix:MS
First Name:ZOILA
Middle Name:M
Last Name:CEDACERO
Suffix:
Gender:F
Credentials:DENTAL HYGIENIST
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2682 VALENTINE AVE APT 1
Mailing Address - Street 2:
Mailing Address - City:BRONX
Mailing Address - State:NY
Mailing Address - Zip Code:10458-3915
Mailing Address - Country:US
Mailing Address - Phone:646-942-7378
Mailing Address - Fax:
Practice Address - Street 1:107 WEST FOURTH STREET
Practice Address - Street 2:
Practice Address - City:MOUNT VERNON
Practice Address - State:NY
Practice Address - Zip Code:10550
Practice Address - Country:US
Practice Address - Phone:914-699-7200
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2010-02-03
Last Update Date:2010-02-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY026015124Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes124Q00000XDental ProvidersDental Hygienist