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General NPI Number Information
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NPI Number | 1194357855
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Entity Type | Organization
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Legal Business Name | ADVANCED TORRANCE DENTAL GROUP
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Dates
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Enumeration Date | 02/10/2020
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Last Update Date | 05/27/2025
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Provider Practice Location Address
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Address Line | 22910 CRENSHAW BLVD STE D
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City | TORRANCE
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State | CA
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Zip | 90505-3060
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Country | US
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Telephone | 310-534-1809
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Fax | 310-534-1079
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Provider Business Mailing Address
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Address Line | 17521 CRENSHAW BLVD
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City | TORRANCE
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State | CA
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Zip | 90504-3403
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Country | US
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Telephone | 310-384-6681
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Fax |
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Authorized Official
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Title or Position | OFFICE
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Name | ROSALBA ESTRELLA
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Credential |
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Telephone | 424-215-8269
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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 |
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License Number State |
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