Provider Demographics
NPI:1629455191
Name:TORRES, AUDREY KAY (RDH)
Entity Type:Individual
Prefix:MRS
First Name:AUDREY
Middle Name:KAY
Last Name:TORRES
Suffix:
Gender:F
Credentials:RDH
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2525 W 16TH ST STE A
Mailing Address - Street 2:
Mailing Address - City:GREELEY
Mailing Address - State:CO
Mailing Address - Zip Code:80634-4951
Mailing Address - Country:US
Mailing Address - Phone:970-352-2344
Mailing Address - Fax:970-352-2001
Practice Address - Street 1:2525 W 16TH ST STE A
Practice Address - Street 2:
Practice Address - City:GREELEY
Practice Address - State:CO
Practice Address - Zip Code:80634-4951
Practice Address - Country:US
Practice Address - Phone:970-352-2344
Practice Address - Fax:970-352-2001
Is Sole Proprietor?:No
Enumeration Date:2015-05-04
Last Update Date:2015-05-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CODH.000906314124Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes124Q00000XDental ProvidersDental Hygienist