MEDICARE: TORODENTAL PLLC

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	1223X0400X	Orthodontics and Dentofacial Orthopedics Dentistry

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1932674033
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	TORODENTAL PLLC

Provider Business Mailing Address
First Line	:	5420 WEBB RD STE D1
Second Line	:
City	:	TAMPA
State	:	FL
Zip	:	33615-3255
Country	:	US
Telephone Number	:	813-886-0545
Fax Number	:	813-514-4869

Provider Business Practice Location Address
First Line	:	5420 WEBB RD STE D1
Second Line	:
City	:	TAMPA
State	:	FL
Zip	:	33615-3255
Country	:	US
Telephone Number	:	813-886-0545
Fax Number	:	813-514-4869

Authorized Official
Title or Position	:	MANAGER
Name	:	DR. EDGARDO J TORO-QUINONES
Credential	:	DMD
Telephone Number	:	787-605-9013

Provider Enumeration Date	:	10/04/2018
Last Update Date	:	10/04/2018

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Directions to “TORODENTAL PLLC ” Practice Location

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