MEDICARE: DR. ALICE G ALATORRE DDS

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	1223G0001X	General Practice Dentistry	DA 30970	CA

General Provider Information

NPI Number	:	1972644987
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. ALICE G ALATORRE DDS

Provider Business Mailing Address
First Line	:	82013 DOCTOR CARREON BLVD
Second Line	:	SUITE D
City	:	INDIO
State	:	CA
Zip	:	92201-5832
Country	:	US
Telephone Number	:	760-775-0087
Fax Number	:

Provider Business Practice Location Address
First Line	:	82013 DOCTOR CARREON BLVD
Second Line	:	SUITE D
City	:	INDIO
State	:	CA
Zip	:	92201-5832
Country	:	US
Telephone Number	:	760-775-0087
Fax Number	:

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

Provider Enumeration Date	:	02/11/2007
Last Update Date	:	07/08/2007

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