Provider Demographics
NPI:1255179594
Name:TORRENS DENTAL OF BONITA
Entity type:Organization
Organization Name:TORRENS DENTAL OF BONITA
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER/DENTIST
Authorized Official - Prefix:
Authorized Official - First Name:WALFRED
Authorized Official - Middle Name:
Authorized Official - Last Name:TORRENS
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:239-273-5245
Mailing Address - Street 1:9260 ISLA BELLA CIR
Mailing Address - Street 2:
Mailing Address - City:BONITA SPRINGS
Mailing Address - State:FL
Mailing Address - Zip Code:34135-7223
Mailing Address - Country:US
Mailing Address - Phone:239-273-5245
Mailing Address - Fax:
Practice Address - Street 1:24600 S TAMIAMI TRL STE 206
Practice Address - Street 2:
Practice Address - City:BONITA SPRINGS
Practice Address - State:FL
Practice Address - Zip Code:34134-7023
Practice Address - Country:US
Practice Address - Phone:239-273-5245
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2024-07-19
Last Update Date:2024-07-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1223G0001XDental ProvidersDentistGeneral PracticeGroup - Single Specialty