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General NPI Number Information
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NPI Number | 1386436863
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Entity Type | Individual
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Provider Name | MARIA REGINA TRINIDAD CAMARA ROXAS DMD, MS
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Gender | Female
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Dates
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Enumeration Date | 05/20/2025
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Last Update Date | 05/20/2025
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Provider Practice Location Address
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Address Line | 883 SNEATH LN # 130
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City | SAN BRUNO
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State | CA
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Zip | 94066-2409
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Country | US
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Telephone | 650-589-4563
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Fax |
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Provider Business Mailing Address
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Address Line | 5700 HIGHLANDS PLAZA DR APT 5051
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City | SAINT LOUIS
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State | MO
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Zip | 63110-1381
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Country | US
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Telephone | 630-746-9122
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 1223X0400X
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Taxonomy Name | Orthodontics and Dentofacial Orthopedics Dentistry
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License Number | 111022
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License Number State | CA
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