MEDICARE: CESAR ANIBAL TORRES GONZALEZ DMD

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	122300000X	Dentist	1612	PR

General Provider Information

NPI Number	:	1265426563
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	CESAR ANIBAL TORRES GONZALEZ DMD

Provider Business Mailing Address
First Line	:	PO BOX 505
Second Line	:
City	:	MOROVIS
State	:	PR
Zip	:	00687-0505
Country	:	US
Telephone Number	:	787-862-4615
Fax Number	:	787-862-4615

Provider Business Practice Location Address
First Line	:	25 CALLE PRINCIPAL
Second Line	:
City	:	MOROVIS
State	:	PR
Zip	:	00687-3048
Country	:	US
Telephone Number	:	787-862-4615
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	09/01/2005
Last Update Date	:	09/27/2016

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