Provider Demographics
NPI:1023006368
Name:ZAMORA, CECILIE C (DMD)
Entity type:Individual
Prefix:DR
First Name:CECILIE
Middle Name:C
Last Name:ZAMORA
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:BOX 1769
Mailing Address - Street 2:
Mailing Address - City:JUNCOS
Mailing Address - State:PR
Mailing Address - Zip Code:00777-1769
Mailing Address - Country:US
Mailing Address - Phone:787-734-1822
Mailing Address - Fax:787-734-3069
Practice Address - Street 1:ROAD # 31
Practice Address - Street 2:JUNCOS PLAZA LOCAL D-4
Practice Address - City:JUNCOS
Practice Address - State:PR
Practice Address - Zip Code:00777
Practice Address - Country:US
Practice Address - Phone:787-713-0511
Practice Address - Fax:787-713-0511
Is Sole Proprietor?:Yes
Enumeration Date:2005-10-11
Last Update Date:2015-01-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PR24281223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice