Provider Demographics
NPI:1154066215
Name:SONRISAS DENTAL LLC
Entity Type:Organization
Organization Name:SONRISAS DENTAL LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:DENTIST
Authorized Official - Prefix:DR
Authorized Official - First Name:JOB
Authorized Official - Middle Name:
Authorized Official - Last Name:TORRES-GOMEZ
Authorized Official - Suffix:
Authorized Official - Credentials:DMD
Authorized Official - Phone:928-273-1244
Mailing Address - Street 1:261 W DUVAL RD
Mailing Address - Street 2:
Mailing Address - City:GREEN VALLEY
Mailing Address - State:AZ
Mailing Address - Zip Code:85614-4356
Mailing Address - Country:US
Mailing Address - Phone:520-625-0131
Mailing Address - Fax:
Practice Address - Street 1:261 W DUVAL RD
Practice Address - Street 2:
Practice Address - City:GREEN VALLEY
Practice Address - State:AZ
Practice Address - Zip Code:85614-4356
Practice Address - Country:US
Practice Address - Phone:520-625-0131
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2022-05-03
Last Update Date:2022-05-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QD0000XAmbulatory Health Care FacilitiesClinic/CenterDental