Provider Demographics
NPI:1841900453
Name:GARCIA TORRES, OLIVA PRISCILA (DDS)
Entity type:Individual
Prefix:
First Name:OLIVA PRISCILA
Middle Name:
Last Name:GARCIA TORRES
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 1:2508 E PALMDALE BLVD
Mailing Address - Street 2:
Mailing Address - City:PALMDALE
Mailing Address - State:CA
Mailing Address - Zip Code:93550-4860
Mailing Address - Country:US
Mailing Address - Phone:661-947-9990
Mailing Address - Fax:661-947-2452
Practice Address - Street 1:2508 E PALMDALE BLVD
Practice Address - Street 2:
Practice Address - City:PALMDALE
Practice Address - State:CA
Practice Address - Zip Code:93550-4860
Practice Address - Country:US
Practice Address - Phone:661-947-9990
Practice Address - Fax:661-917-2452
Is Sole Proprietor?:Yes
Enumeration Date:2022-12-05
Last Update Date:2022-12-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA108339122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist