Provider Demographics
NPI:1083690895
Name:TORRES, ERIC XAVIER (DMD, MHP)
Entity Type:Individual
Prefix:DR
First Name:ERIC
Middle Name:XAVIER
Last Name:TORRES
Suffix:
Gender:M
Credentials:DMD, MHP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4 COND SAN FERNANDO VLG APT 327
Mailing Address - Street 2:
Mailing Address - City:CAROLINA
Mailing Address - State:PR
Mailing Address - Zip Code:00987-6964
Mailing Address - Country:US
Mailing Address - Phone:787-485-9142
Mailing Address - Fax:
Practice Address - Street 1:AVE ROBERTO CLEMENTE
Practice Address - Street 2:BLQ 33 NO.4
Practice Address - City:CAROLINA
Practice Address - State:PR
Practice Address - Zip Code:00985
Practice Address - Country:US
Practice Address - Phone:787-768-7216
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2005-12-22
Last Update Date:2010-07-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PR25611223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice