Provider Demographics
NPI:1659025823
Name:TORO, MARILISA ELIZABETTA (DDS)
Entity Type:Individual
Prefix:DR
First Name:MARILISA
Middle Name:ELIZABETTA
Last Name:TORO
Suffix:
Gender:F
Credentials:DDS
Other - Prefix:
Other - First Name:MARILISA
Other - Middle Name:
Other - Last Name:AYERS
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:PO BOX 33081
Mailing Address - Street 2:
Mailing Address - City:RIVERSIDE
Mailing Address - State:CA
Mailing Address - Zip Code:92519-0081
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:3950 PIERCE ST STE L
Practice Address - Street 2:
Practice Address - City:RIVERSIDE
Practice Address - State:CA
Practice Address - Zip Code:92505-3809
Practice Address - Country:US
Practice Address - Phone:951-643-4405
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2022-02-07
Last Update Date:2023-07-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CADDS107211122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist