=====================================================
General NPI Number Information
=====================================================
NPI Number | 1750186912
-----------------------------------------------------
Entity Type | Organization
-----------------------------------------------------
Legal Business Name | TORRECH DENTAL SUITE PSC
-----------------------------------------------------
=====================================================
Dates
=====================================================
Enumeration Date | 02/13/2025
-----------------------------------------------------
Last Update Date | 02/13/2025
-----------------------------------------------------
=====================================================
Provider Practice Location Address
=====================================================
Address Line | 400 CARR 2
-----------------------------------------------------
City | VEGA ALTA
-----------------------------------------------------
State | PR
-----------------------------------------------------
Zip | 00692-6069
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 787-231-7937
-----------------------------------------------------
Fax |
-----------------------------------------------------
=====================================================
Provider Business Mailing Address
=====================================================
Address Line | 1500 AVE SAN IGNACIO APT 19
-----------------------------------------------------
City | SAN JUAN
-----------------------------------------------------
State | PR
-----------------------------------------------------
Zip | 00921-4756
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 787-381-4183
-----------------------------------------------------
Fax |
-----------------------------------------------------
=====================================================
Authorized Official
=====================================================
Title or Position | OWNER/DENTIST
-----------------------------------------------------
Name | DR. RAFAEL ADOLFO TORRECH SANTOS
-----------------------------------------------------
Credential | DMD
-----------------------------------------------------
Telephone | 787-381-4183
-----------------------------------------------------
=====================================================
Scope of Practice (Provider's specialty)
=====================================================
Taxonomy #1
-----------------------------------------------------
Taxonomy Code | 261QD0000X
-----------------------------------------------------
Taxonomy Name | Dental Clinic/Center
-----------------------------------------------------
License Number |
-----------------------------------------------------
License Number State |
-----------------------------------------------------