Healthcare Provider Details

I. General information

NPI: 1265426563
Provider Name (Legal Business Name): CESAR ANIBAL TORRES GONZALEZ DMD
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 09/01/2005
Last Update Date: 09/27/2016
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

25 CALLE PRINCIPAL
MOROVIS PR
00687-3048
US

IV. Provider business mailing address

PO BOX 505
MOROVIS PR
00687-0505
US

V. Phone/Fax

Practice location:
  • Phone: 787-862-4615
  • Fax:
Mailing address:
  • Phone: 787-862-4615
  • Fax: 787-862-4615

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code122300000X
TaxonomyDentist
License Number1612
License Number StatePR

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: