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General NPI Number Information
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NPI Number | 1811126261
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Entity Type | Individual
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Provider Name | KEYLA IVETTE TORRES DMD, MS
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Gender | Female
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Dates
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Enumeration Date | 07/07/2009
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Last Update Date | 04/28/2020
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Provider Practice Location Address
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Address Line | 6395 DOBBIN RD STE 208
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City | COLUMBIA
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State | MD
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Zip | 21045-4759
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Country | US
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Telephone | 410-997-1189
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Fax | 412-992-5474
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Provider Business Mailing Address
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Address Line | 6395 DOBBIN RD STE 208
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City | COLUMBIA
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State | MD
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Zip | 21045-4759
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Country | US
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Telephone | 410-997-1189
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Fax | 410-992-5474
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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 | 1223P0300X
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Taxonomy Name | Periodontics
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License Number | 2757
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License Number State | PR
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