Provider Demographics
NPI:1457582355
Name:TORRES, KENNETH OCHOA (DDS)
Entity Type:Individual
Prefix:DR
First Name:KENNETH
Middle Name:OCHOA
Last Name:TORRES
Suffix:
Gender:M
Credentials:DDS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:579 FLORESTA BLVD STE D
Mailing Address - Street 2:
Mailing Address - City:SAN LEANDRO
Mailing Address - State:CA
Mailing Address - Zip Code:94578-4124
Mailing Address - Country:US
Mailing Address - Phone:510-895-8191
Mailing Address - Fax:510-895-8219
Practice Address - Street 1:579 FLORESTA BLVD STE D
Practice Address - Street 2:
Practice Address - City:SAN LEANDRO
Practice Address - State:CA
Practice Address - Zip Code:94578-4124
Practice Address - Country:US
Practice Address - Phone:510-895-8191
Practice Address - Fax:510-895-8219
Is Sole Proprietor?:No
Enumeration Date:2009-07-27
Last Update Date:2011-10-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA579971223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice