Provider Demographics
NPI:1760157135
Name:TORIO, CHANTAL CRUZ (DDS)
Entity Type:Individual
Prefix:DR
First Name:CHANTAL
Middle Name:CRUZ
Last Name:TORIO
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 1:737 PINE ST APT 42
Mailing Address - Street 2:
Mailing Address - City:SAN FRANCISCO
Mailing Address - State:CA
Mailing Address - Zip Code:94108-3121
Mailing Address - Country:US
Mailing Address - Phone:848-219-2017
Mailing Address - Fax:
Practice Address - Street 1:737 PINE ST APT 42
Practice Address - Street 2:
Practice Address - City:SAN FRANCISCO
Practice Address - State:CA
Practice Address - Zip Code:94108-3121
Practice Address - Country:US
Practice Address - Phone:848-219-2017
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2021-08-09
Last Update Date:2021-08-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA1067631223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice