Provider Demographics
NPI:1336276088
Name:TORRES, MICHELLE ALICIA (DDS)
Entity Type:Individual
Prefix:DR
First Name:MICHELLE
Middle Name:ALICIA
Last Name:TORRES
Suffix:
Gender:F
Credentials:DDS
Other - Prefix:
Other - First Name:
Other - Middle Name:
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Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:20445 PROSPECT RD
Mailing Address - Street 2:STE 4
Mailing Address - City:SAN JOSE
Mailing Address - State:CA
Mailing Address - Zip Code:95129
Mailing Address - Country:US
Mailing Address - Phone:408-446-2200
Mailing Address - Fax:408-446-1040
Practice Address - Street 1:20445 PROSPECT RD
Practice Address - Street 2:SUITE 4
Practice Address - City:SAN JOSE
Practice Address - State:CA
Practice Address - Zip Code:95129
Practice Address - Country:US
Practice Address - Phone:408-446-2200
Practice Address - Fax:408-446-1040
Is Sole Proprietor?:No
Enumeration Date:2007-02-28
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
CA413151223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice