MEDICARE: MS. CARMEN S. TORRES RDH

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	124Q00000X	Dental Hygienist	075	PR

General Provider Information

NPI Number	:	1851392443
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MS. CARMEN S. TORRES RDH

Provider Business Mailing Address
First Line	:	COND DALIA HILLS
Second Line	:	K20 CALLE 1 APT. 43
City	:	BAYAMON
State	:	PR
Zip	:	00959-7817
Country	:	US
Telephone Number	:	787-486-6297
Fax Number	:	787-707-3494

Provider Business Practice Location Address
First Line	:	BLDG. 312 CHRISMAN ST
Second Line	:	FT. BUCHANAN DENTAL CLINIC
City	:	FT. BUCHANAN
State	:	PR
Zip	:	00934-5066
Country	:	US
Telephone Number	:	787-707-2040
Fax Number	:	787-707-3494

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	08/03/2005
Last Update Date	:	07/08/2007

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