Provider Demographics
NPI:1639406002
Name:TORO ESPECIALISTAS EN ORTODONCIA, CSP
Entity Type:Organization
Organization Name:TORO ESPECIALISTAS EN ORTODONCIA, CSP
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:LUIS
Authorized Official - Middle Name:ALBERTO
Authorized Official - Last Name:TORO
Authorized Official - Suffix:
Authorized Official - Credentials:DDS, MS
Authorized Official - Phone:787-860-7943
Mailing Address - Street 1:FAJARDO CARIBBEAN CINEMAS
Mailing Address - Street 2:SUITE 205
Mailing Address - City:FAJARDO
Mailing Address - State:PR
Mailing Address - Zip Code:00738
Mailing Address - Country:US
Mailing Address - Phone:787-860-7943
Mailing Address - Fax:787-860-7113
Practice Address - Street 1:FAJARDO CARIBBEAN CINEMAS
Practice Address - Street 2:SUITE 205
Practice Address - City:FAJARDO
Practice Address - State:PR
Practice Address - Zip Code:00738
Practice Address - Country:US
Practice Address - Phone:787-860-7943
Practice Address - Fax:787-860-7113
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2009-11-05
Last Update Date:2009-11-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PR14481223X0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1223X0400XDental ProvidersDentistOrthodontics and Dentofacial OrthopedicsGroup - Multi-Specialty