Provider Demographics
NPI:1710920889
Name:TORRES PILLICH, MARIA IDAMIS (DDS)
Entity Type:Individual
Prefix:
First Name:MARIA
Middle Name:IDAMIS
Last Name:TORRES PILLICH
Suffix:
Gender:F
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:B23 CALLE ARAWAK
Mailing Address - Street 2:URB. CAGUAX
Mailing Address - City:CAGUAS
Mailing Address - State:PR
Mailing Address - Zip Code:00725-3305
Mailing Address - Country:US
Mailing Address - Phone:787-746-8335
Mailing Address - Fax:
Practice Address - Street 1:CALLE LUIS MUNOZ RIVERA #2
Practice Address - Street 2:
Practice Address - City:CAYEY
Practice Address - State:PR
Practice Address - Zip Code:00737
Practice Address - Country:US
Practice Address - Phone:787-738-7370
Practice Address - Fax:787-739-7370
Is Sole Proprietor?:No
Enumeration Date:2006-06-14
Last Update Date:2009-11-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PR2497122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist