Provider Demographics
NPI:1972644987
Name:ALATORRE, ALICE G (DDS)
Entity Type:Individual
Prefix:DR
First Name:ALICE
Middle Name:G
Last Name:ALATORRE
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 1:82013 DOCTOR CARREON BLVD
Mailing Address - Street 2:SUITE D
Mailing Address - City:INDIO
Mailing Address - State:CA
Mailing Address - Zip Code:92201-5832
Mailing Address - Country:US
Mailing Address - Phone:760-775-0087
Mailing Address - Fax:
Practice Address - Street 1:82013 DOCTOR CARREON BLVD
Practice Address - Street 2:SUITE D
Practice Address - City:INDIO
Practice Address - State:CA
Practice Address - Zip Code:92201-5832
Practice Address - Country:US
Practice Address - Phone:760-775-0087
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-02-11
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CADA 309701223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice