Provider Demographics
NPI:1922650076
Name:BRANDON DEL TORO DDS PLLC
Entity Type:Organization
Organization Name:BRANDON DEL TORO DDS PLLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:BRANDON
Authorized Official - Middle Name:
Authorized Official - Last Name:DEL TORO
Authorized Official - Suffix:
Authorized Official - Credentials:DDS
Authorized Official - Phone:435-313-9119
Mailing Address - Street 1:2333 LAMAR AVE
Mailing Address - Street 2:
Mailing Address - City:PARIS
Mailing Address - State:TX
Mailing Address - Zip Code:75460-4757
Mailing Address - Country:US
Mailing Address - Phone:903-785-7671
Mailing Address - Fax:
Practice Address - Street 1:2333 LAMAR AVE
Practice Address - Street 2:
Practice Address - City:PARIS
Practice Address - State:TX
Practice Address - Zip Code:75460-4757
Practice Address - Country:US
Practice Address - Phone:903-785-7671
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2019-07-09
Last Update Date:2019-07-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QD0000XAmbulatory Health Care FacilitiesClinic/CenterDental
Provider Identifiers
StateIdentifier IDID TypeIssuer
1215288311OtherNATIONAL PROVDER IDENTIFICATION
TX395872001OtherTEXAS PROVIDER IDENTIFICATION