Provider Demographics
NPI:1811018922
Name:SEGURA, MARIA LUCIA (DMD)
Entity Type:Individual
Prefix:DR
First Name:MARIA
Middle Name:LUCIA
Last Name:SEGURA
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 1:100 VILLAGE DR
Mailing Address - Street 2:
Mailing Address - City:QUINCY
Mailing Address - State:MA
Mailing Address - Zip Code:02169-0946
Mailing Address - Country:US
Mailing Address - Phone:617-472-2643
Mailing Address - Fax:
Practice Address - Street 1:304 PLEASANT ST.
Practice Address - Street 2:
Practice Address - City:BROCKTON
Practice Address - State:MA
Practice Address - Zip Code:02401
Practice Address - Country:US
Practice Address - Phone:508-588-0094
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2007-04-03
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MA198831223P0221X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223P0221XDental ProvidersDentistPediatric Dentistry