Provider Demographics
NPI:1043228901
Name:CARLOS R TORRES DDS & SONIA CASTELLON DDS INC
Entity Type:Organization
Organization Name:CARLOS R TORRES DDS & SONIA CASTELLON DDS INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:VICE PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:SONIA
Authorized Official - Middle Name:A
Authorized Official - Last Name:CASTELLON
Authorized Official - Suffix:
Authorized Official - Credentials:DDS
Authorized Official - Phone:818-895-2328
Mailing Address - Street 1:9523 VAN NUYS BLVD
Mailing Address - Street 2:
Mailing Address - City:PANORAMA CITY
Mailing Address - State:CA
Mailing Address - Zip Code:91402-1313
Mailing Address - Country:US
Mailing Address - Phone:818-895-2328
Mailing Address - Fax:818-895-0318
Practice Address - Street 1:9523 VAN NUYS BLVD
Practice Address - Street 2:
Practice Address - City:PANORAMA CITY
Practice Address - State:CA
Practice Address - Zip Code:91402-1313
Practice Address - Country:US
Practice Address - Phone:818-895-2328
Practice Address - Fax:818-895-0318
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-08-04
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA36639122300000X
CA40210122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes122300000XDental ProvidersDentistGroup - Multi-Specialty