Provider Demographics
NPI:1225022577
Name:TORRES-RODRIGUEZ, CONNIE MERCED (DMD)
Entity Type:Individual
Prefix:
First Name:CONNIE
Middle Name:MERCED
Last Name:TORRES-RODRIGUEZ
Suffix:
Gender:F
Credentials:DMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 66
Mailing Address - Street 2:
Mailing Address - City:RINCON
Mailing Address - State:PR
Mailing Address - Zip Code:00677-0066
Mailing Address - Country:US
Mailing Address - Phone:787-823-1329
Mailing Address - Fax:
Practice Address - Street 1:19 CALLE COMERCIO
Practice Address - Street 2:
Practice Address - City:RINCON
Practice Address - State:PR
Practice Address - Zip Code:00677-2203
Practice Address - Country:US
Practice Address - Phone:787-823-1329
Practice Address - Fax:
Is Sole Proprietor?:Not Answered
Enumeration Date:2005-09-01
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PR23551223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice