Healthcare Provider Details

I. General information

NPI: 1689550006
Provider Name (Legal Business Name): TORMOR DENTAL PR LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 08/12/2025
Last Update Date: 08/12/2025
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

82 PASEO DE LAS ATENAS
MANATI PR
00674-5377
US

IV. Provider business mailing address

PO BOX 43
MANATI PR
00674-5377
US

V. Phone/Fax

Practice location:
  • Phone: 787-884-0417
  • Fax:
Mailing address:
  • Phone: 787-884-0417
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1223P0221X
TaxonomyPediatric Dentistry
License Number
License Number State

VII. Legacy identifiers

For crosswalk purposes, the following legacy (non-NPI) identifiers are available for this provider:

VIII. Authorized Official

Name: MRS. EVELYN MULERO
Title or Position: ADMINISTRADORA
Credential:
Phone: 787-525-6521