Healthcare Provider Details

I. General information

NPI: 1154512192
Provider Name (Legal Business Name): MARCO ANTONIO TORRADO DMD,MS
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 08/06/2007
Last Update Date: 08/06/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

STATE ROUTE #2, KM 87.7, AVE.PABLO J. AGUILAR BO.PUEBLO
HATILLO PR
00659-1848
US

IV. Provider business mailing address

STATE ROUTE #2, KM 87.7,AVE.PABLO J. AGUILAR,BO. PUEBLO BOX 1848
HATILLO PR
00659-1848
US

V. Phone/Fax

Practice location:
  • Phone: 787-262-5800
  • Fax: 787-262-5900
Mailing address:
  • Phone: 787-262-5800
  • Fax: 787-262-5900

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1223X0400X
TaxonomyOrthodontics and Dentofacial Orthopedics Dentistry
License Number2706
License Number StatePR

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: