Provider Demographics
NPI:1710221643
Name:NEGRON, ZORAIMA DE LOURDES (DMD)
Entity Type:Individual
Prefix:DR
First Name:ZORAIMA
Middle Name:DE LOURDES
Last Name:NEGRON
Suffix:
Gender:F
Credentials:DMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:380 CALLE CESAR GONZALEZ
Mailing Address - Street 2:HATO REY
Mailing Address - City:SAN JUAN
Mailing Address - State:PR
Mailing Address - Zip Code:00918
Mailing Address - Country:US
Mailing Address - Phone:787-374-3287
Mailing Address - Fax:787-758-3858
Practice Address - Street 1:380 CALLE CESAR GONZALEZ
Practice Address - Street 2:HATO REY
Practice Address - City:SAN JUAN
Practice Address - State:PR
Practice Address - Zip Code:00918
Practice Address - Country:US
Practice Address - Phone:787-374-3287
Practice Address - Fax:787-758-3858
Is Sole Proprietor?:No
Enumeration Date:2012-11-15
Last Update Date:2012-11-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PR29101223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice