Provider Demographics
NPI:1710617790
Name:TORRES, VICTOR (DMD)
Entity Type:Individual
Prefix:
First Name:VICTOR
Middle Name:
Last Name:TORRES
Suffix:
Gender:M
Credentials:DMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:6774 W DEL MAR LN
Mailing Address - Street 2:
Mailing Address - City:PEORIA
Mailing Address - State:AZ
Mailing Address - Zip Code:85381-4507
Mailing Address - Country:US
Mailing Address - Phone:775-772-2070
Mailing Address - Fax:
Practice Address - Street 1:6774 W DEL MAR LN
Practice Address - Street 2:
Practice Address - City:PEORIA
Practice Address - State:AZ
Practice Address - Zip Code:85381-4507
Practice Address - Country:US
Practice Address - Phone:775-772-2070
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2022-06-13
Last Update Date:2022-06-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AZD011417122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist