Provider Demographics
NPI:1902082373
Name:SANTIAGO, ZULMARIE (DMD)
Entity Type:Individual
Prefix:DR
First Name:ZULMARIE
Middle Name:
Last Name:SANTIAGO
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:CLINICA LAS AMERICAS
Mailing Address - Street 2:SUITE 506, F.D. ROOSEVELT #400
Mailing Address - City:SAN JUAN
Mailing Address - State:PR
Mailing Address - Zip Code:00918-2103
Mailing Address - Country:US
Mailing Address - Phone:787-250-0907
Mailing Address - Fax:
Practice Address - Street 1:CLINICA LAS AMERICAS
Practice Address - Street 2:SUITE 506, F.D. ROOSEVELT #400
Practice Address - City:SAN JUAN
Practice Address - State:PR
Practice Address - Zip Code:00918-2103
Practice Address - Country:US
Practice Address - Phone:787-250-0907
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2008-01-16
Last Update Date:2008-01-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PR25781223E0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223E0200XDental ProvidersDentistEndodontics