Provider Demographics
NPI:1518009604
Name:ZORRILLA LASSUS, RAMON A (DMD)
Entity Type:Individual
Prefix:DR
First Name:RAMON
Middle Name:A
Last Name:ZORRILLA LASSUS
Suffix:
Gender:M
Credentials:DMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
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Other - Credentials:
Mailing Address - Street 1:PO BOX 488
Mailing Address - Street 2:
Mailing Address - City:BAYAMON
Mailing Address - State:PR
Mailing Address - Zip Code:00960-0488
Mailing Address - Country:US
Mailing Address - Phone:787-740-1665
Mailing Address - Fax:787-269-4045
Practice Address - Street 1:CALLE J ESQUINA CALLE B EDIFICIO MEDICO HNAS. DAVILA
Practice Address - Street 2:OFICINA # 201
Practice Address - City:BAYAMON
Practice Address - State:PR
Practice Address - Zip Code:00959
Practice Address - Country:US
Practice Address - Phone:787-740-1665
Practice Address - Fax:787-269-4045
Is Sole Proprietor?:Yes
Enumeration Date:2007-02-13
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PR10721223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice