Provider Demographics
NPI:1629284864
Name:ZECCA-BOTWIN, MARIA (DMD)
Entity type:Individual
Prefix:DR
First Name:MARIA
Middle Name:
Last Name:ZECCA-BOTWIN
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 1:83 ROYAL PALM PT
Mailing Address - Street 2:
Mailing Address - City:VERO BEACH
Mailing Address - State:FL
Mailing Address - Zip Code:32960-4253
Mailing Address - Country:US
Mailing Address - Phone:772-257-6101
Mailing Address - Fax:772-257-6102
Practice Address - Street 1:83 ROYAL PALM PT
Practice Address - Street 2:
Practice Address - City:VERO BEACH
Practice Address - State:FL
Practice Address - Zip Code:32960-4253
Practice Address - Country:US
Practice Address - Phone:772-257-6101
Practice Address - Fax:772-257-6102
Is Sole Proprietor?:No
Enumeration Date:2007-05-15
Last Update Date:2024-07-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLDN173051223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice