Provider Demographics
NPI:1588761134
Name:ZEQUEIRA, RAMON A (DMD,MSD)
Entity type:Individual
Prefix:DR
First Name:RAMON
Middle Name:A
Last Name:ZEQUEIRA
Suffix:
Gender:M
Credentials:DMD,MSD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:86 HARBOUR LIGHTS DR
Mailing Address - Street 2:PALMAS DEL MAR
Mailing Address - City:HUMACAO
Mailing Address - State:PR
Mailing Address - Zip Code:00791-6032
Mailing Address - Country:US
Mailing Address - Phone:787-258-2830
Mailing Address - Fax:
Practice Address - Street 1:86 HARBOUR LIGHTS DR
Practice Address - Street 2:PALMAS DEL MAR
Practice Address - City:HUMACAO
Practice Address - State:PR
Practice Address - Zip Code:00791-6032
Practice Address - Country:US
Practice Address - Phone:787-258-2830
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2006-09-17
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PR15411223E0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223E0200XDental ProvidersDentistEndodontics