Healthcare Provider Details

I. General information

NPI: 1336100221
Provider Name (Legal Business Name): ANGEL MANUEL TORRES DMD
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 03/30/2006
Last Update Date: 02/16/2017
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

MUNOZ RIVERA #56
SANTA ISABEL PR
00757
US

IV. Provider business mailing address

PO BOX 2368
COAMO PR
00769-4368
US

V. Phone/Fax

Practice location:
  • Phone: 787-845-6706
  • Fax: 787-845-6706
Mailing address:
  • Phone: 787-845-6706
  • Fax: 787-845-6706

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code122300000X
TaxonomyDentist
License NumberD2082
License Number StatePR

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: