Provider Demographics
NPI:1770759045
Name:CENICEROS, LILA SEA I (DMD)
Entity type:Individual
Prefix:DR
First Name:LILA
Middle Name:SEA
Last Name:CENICEROS
Suffix:I
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 1:2440 MISSION ST
Mailing Address - Street 2:
Mailing Address - City:SAN FRANCISCO
Mailing Address - State:CA
Mailing Address - Zip Code:94110-2415
Mailing Address - Country:US
Mailing Address - Phone:415-285-9900
Mailing Address - Fax:415-285-7553
Practice Address - Street 1:2440 MISSION ST
Practice Address - Street 2:
Practice Address - City:SAN FRANCISCO
Practice Address - State:CA
Practice Address - Zip Code:94110-2415
Practice Address - Country:US
Practice Address - Phone:415-285-9900
Practice Address - Fax:415-285-7553
Is Sole Proprietor?:No
Enumeration Date:2008-05-06
Last Update Date:2008-05-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA539771223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice