Provider Demographics
NPI:1245314095
Name:GARCIA CERRA, MARTA M (DMD)
Entity type:Individual
Prefix:
First Name:MARTA
Middle Name:M
Last Name:GARCIA CERRA
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:URB LOS MAESTROS 212 LA HIJA DEL CARIBE
Mailing Address - Street 2:
Mailing Address - City:HATO REY
Mailing Address - State:PR
Mailing Address - Zip Code:00918
Mailing Address - Country:US
Mailing Address - Phone:787-765-8176
Mailing Address - Fax:787-765-8176
Practice Address - Street 1:124 AVE WINSTON CHURCHILL
Practice Address - Street 2:SUITE #3 CROWN HILL RIO PIEDRAS
Practice Address - City:SAN JUAN
Practice Address - State:PR
Practice Address - Zip Code:00926-6064
Practice Address - Country:US
Practice Address - Phone:787-765-8176
Practice Address - Fax:787-765-8476
Is Sole Proprietor?:No
Enumeration Date:2006-10-25
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PR1625122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist