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General NPI Number Information
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NPI Number | 1194330597
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Entity Type | Individual
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Provider Name | MILTON EDUARDO TORRES CABAN DMD
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Gender | Male
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Dates
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Enumeration Date | 09/11/2020
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Last Update Date | 09/11/2020
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Provider Practice Location Address
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Address Line | 3661 SANGANI BLVD
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City | DIBERVILLE
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State | MS
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Zip | 39540-8706
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Country | US
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Telephone | 228-456-3197
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Fax |
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Provider Business Mailing Address
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Address Line | 1 REPARTO ROBLES
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City | SAN ANTONIO
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State | PR
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Zip | 00690
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Country | US
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Telephone | 787-516-4474
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 1223G0001X
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Taxonomy Name | General Practice Dentistry
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License Number | 4163-20
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License Number State | MS
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