Provider Demographics
NPI:1588659379
Name:TORTORELLI, ALFRED FRANCIS (DDS)
Entity Type:Individual
Prefix:DR
First Name:ALFRED
Middle Name:FRANCIS
Last Name:TORTORELLI
Suffix:
Gender:M
Credentials:DDS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:182 BABYLON LN
Mailing Address - Street 2:
Mailing Address - City:INDIALANTIC
Mailing Address - State:FL
Mailing Address - Zip Code:32903-2083
Mailing Address - Country:US
Mailing Address - Phone:321-777-0579
Mailing Address - Fax:
Practice Address - Street 1:182 BABYLON LN
Practice Address - Street 2:
Practice Address - City:INDIALANTIC
Practice Address - State:FL
Practice Address - Zip Code:32903-2083
Practice Address - Country:US
Practice Address - Phone:321-777-0579
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2005-09-16
Last Update Date:2007-07-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLDN90031223S0112X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223S0112XDental ProvidersDentistOral and Maxillofacial Surgery