Provider Demographics
NPI:1396882825
Name:TORRES CORREA, JOSE J (DMD)
Entity type:Individual
Prefix:DR
First Name:JOSE
Middle Name:J
Last Name:TORRES CORREA
Suffix:
Gender:M
Credentials:DMD
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Other - Credentials:
Mailing Address - Street 1:VILLA SERENA
Mailing Address - Street 2:55 CALLE LOIRE
Mailing Address - City:SANTA ISABEL
Mailing Address - State:PR
Mailing Address - Zip Code:00757-2546
Mailing Address - Country:US
Mailing Address - Phone:787-743-4213
Mailing Address - Fax:787-743-4213
Practice Address - Street 1:202 JOSE GAUTIER BENITEZ AVE.
Practice Address - Street 2:CONSOLIDATED MALL C1D-EXT.
Practice Address - City:CAGUAS
Practice Address - State:PR
Practice Address - Zip Code:00725
Practice Address - Country:US
Practice Address - Phone:787-743-4213
Practice Address - Fax:787-743-4213
Is Sole Proprietor?:Yes
Enumeration Date:2007-02-01
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
PR17551223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice