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General NPI Number Information
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NPI Number | 1609602846
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Entity Type | Individual
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Provider Name | MARYSNEY TORRES ULLOA DMD
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Gender | Female
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Dates
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Enumeration Date | 09/13/2024
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Last Update Date | 09/13/2024
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Provider Practice Location Address
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Address Line | 14050 SW 84TH ST STE 103
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City | MIAMI
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State | FL
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Zip | 33183-4440
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Country | US
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Telephone | 305-383-9944
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Fax |
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Provider Business Mailing Address
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Address Line | 14825 SW 84TH TER
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City | MIAMI
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State | FL
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Zip | 33193-1586
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Country | US
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Telephone | 786-985-4106
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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 | 122300000X
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Taxonomy Name | Dentist
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License Number | DN29635
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License Number State | FL
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