Provider Demographics
NPI:1215534698
Name:M. TORRES A PROFESSIONAL DENTAL CORPORATION
Entity Type:Organization
Organization Name:M. TORRES A PROFESSIONAL DENTAL CORPORATION
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:MARTHA
Authorized Official - Middle Name:HILDA
Authorized Official - Last Name:TORRES BENITEZ
Authorized Official - Suffix:
Authorized Official - Credentials:DDS
Authorized Official - Phone:949-561-2302
Mailing Address - Street 1:2723 N BRISTOL ST STE D7
Mailing Address - Street 2:
Mailing Address - City:SANTA ANA
Mailing Address - State:CA
Mailing Address - Zip Code:92706-1419
Mailing Address - Country:US
Mailing Address - Phone:714-569-0021
Mailing Address - Fax:
Practice Address - Street 1:2723 N BRISTOL ST STE D7
Practice Address - Street 2:
Practice Address - City:SANTA ANA
Practice Address - State:CA
Practice Address - Zip Code:92706-1419
Practice Address - Country:US
Practice Address - Phone:714-569-0021
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2020-10-08
Last Update Date:2020-10-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1223G0001XDental ProvidersDentistGeneral PracticeGroup - Single Specialty