Provider Demographics
NPI:1871896399
Name:BRENDA L. TORRES RIVERA DENTAL PRACTICE, PSC
Entity type:Organization
Organization Name:BRENDA L. TORRES RIVERA DENTAL PRACTICE, PSC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:MRS
Authorized Official - First Name:BRENDA
Authorized Official - Middle Name:LIZ
Authorized Official - Last Name:TORRES
Authorized Official - Suffix:
Authorized Official - Credentials:DMD
Authorized Official - Phone:787-268-1898
Mailing Address - Street 1:PG80 VIA ARCOIRIS
Mailing Address - Street 2:ENCANTADA
Mailing Address - City:TRUJILLO ALTO
Mailing Address - State:PR
Mailing Address - Zip Code:00976-6195
Mailing Address - Country:US
Mailing Address - Phone:787-236-4401
Mailing Address - Fax:
Practice Address - Street 1:CALLE JUPITER 30A ATLANTIC VIEW
Practice Address - Street 2:
Practice Address - City:CAROLINA
Practice Address - State:PR
Practice Address - Zip Code:00979
Practice Address - Country:US
Practice Address - Phone:787-236-4401
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2010-12-07
Last Update Date:2010-12-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PR24051223P0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1223P0700XDental ProvidersDentistProsthodonticsGroup - Single Specialty