Provider Demographics
NPI:1124212592
Name:C R TORRES DDS. A PROFESSIONAL DENTAL CORPORATION
Entity Type:Organization
Organization Name:C R TORRES DDS. A PROFESSIONAL DENTAL CORPORATION
Other - Org Name:NORWALK CERRITOS FAMILY DENTISTRY
Other - Org Type:Doing Business As
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:CARLOS
Authorized Official - Middle Name:RAMON
Authorized Official - Last Name:TORRES
Authorized Official - Suffix:
Authorized Official - Credentials:DDS
Authorized Official - Phone:562-462-9120
Mailing Address - Street 1:10973 ROSECRANS AVE
Mailing Address - Street 2:
Mailing Address - City:NORWALK
Mailing Address - State:CA
Mailing Address - Zip Code:90650-3581
Mailing Address - Country:US
Mailing Address - Phone:562-462-9120
Mailing Address - Fax:562-462-9122
Practice Address - Street 1:10973 ROSECRANS AVE
Practice Address - Street 2:
Practice Address - City:NORWALK
Practice Address - State:CA
Practice Address - Zip Code:90650-3581
Practice Address - Country:US
Practice Address - Phone:562-462-9120
Practice Address - Fax:562-462-9122
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-08-29
Last Update Date:2007-08-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA36639122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes122300000XDental ProvidersDentistGroup - Single Specialty