Provider Demographics
NPI:1215157458
Name:DELA RAMA, MARJORIE GARCIA (DMD)
Entity type:Individual
Prefix:DR
First Name:MARJORIE
Middle Name:GARCIA
Last Name:DELA RAMA
Suffix:
Gender:F
Credentials:DMD
Other - Prefix:DR
Other - First Name:MARJORIE
Other - Middle Name:
Other - Last Name:GARCIA
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:DMD
Mailing Address - Street 1:980 KING PLZ
Mailing Address - Street 2:DALY CITY
Mailing Address - City:DALY CITY
Mailing Address - State:CA
Mailing Address - Zip Code:94015-4450
Mailing Address - Country:US
Mailing Address - Phone:650-878-0651
Mailing Address - Fax:650-878-9575
Practice Address - Street 1:980 KING PLZ
Practice Address - Street 2:DALY CITY
Practice Address - City:DALY CITY
Practice Address - State:CA
Practice Address - Zip Code:94015-4450
Practice Address - Country:US
Practice Address - Phone:650-878-0651
Practice Address - Fax:650-878-9575
Is Sole Proprietor?:Yes
Enumeration Date:2007-04-30
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA542571223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice