Provider Demographics
NPI:1982819108
Name:TORRE, JESSICA NOEL (DDS)
Entity Type:Individual
Prefix:DR
First Name:JESSICA
Middle Name:NOEL
Last Name:TORRE
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 1:37 OLD SOUTH RD APT 1
Mailing Address - Street 2:
Mailing Address - City:NANTUCKET
Mailing Address - State:MA
Mailing Address - Zip Code:02554-7003
Mailing Address - Country:US
Mailing Address - Phone:508-228-2699
Mailing Address - Fax:508-228-2907
Practice Address - Street 1:37 OLD SOUTH RD APT 1
Practice Address - Street 2:
Practice Address - City:NANTUCKET
Practice Address - State:MA
Practice Address - Zip Code:02554-7003
Practice Address - Country:US
Practice Address - Phone:508-228-2699
Practice Address - Fax:508-228-2907
Is Sole Proprietor?:Yes
Enumeration Date:2007-05-11
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MA20905122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist