Provider Demographics
NPI:1295046662
Name:SEGRERA, MARIA CLAUDIA (DMD)
Entity type:Individual
Prefix:MRS
First Name:MARIA
Middle Name:CLAUDIA
Last Name:SEGRERA
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 1:10700 NW 66TH ST APT 409
Mailing Address - Street 2:
Mailing Address - City:DORAL
Mailing Address - State:FL
Mailing Address - Zip Code:33178-5507
Mailing Address - Country:US
Mailing Address - Phone:954-270-9904
Mailing Address - Fax:
Practice Address - Street 1:10700 NW 66 ST APT. 409
Practice Address - Street 2:
Practice Address - City:DORAL
Practice Address - State:FL
Practice Address - Zip Code:33178
Practice Address - Country:US
Practice Address - Phone:954-270-9904
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2010-06-30
Last Update Date:2010-06-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLDN 19055122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist