Provider Demographics
NPI:1124096995
Name:TORREBIARTE, CARLOS E (DDS)
Entity type:Individual
Prefix:DR
First Name:CARLOS
Middle Name:E
Last Name:TORREBIARTE
Suffix:
Gender:M
Credentials:DDS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3730 ELLISON DRIVE NW
Mailing Address - Street 2:SUITE B
Mailing Address - City:ALBUQUERQUE
Mailing Address - State:NM
Mailing Address - Zip Code:87114-7009
Mailing Address - Country:US
Mailing Address - Phone:505-766-4800
Mailing Address - Fax:505-898-5270
Practice Address - Street 1:3730 ELLISON DRIVE NW
Practice Address - Street 2:SUITE B
Practice Address - City:ALBUQUERQUE
Practice Address - State:NM
Practice Address - Zip Code:87114-7009
Practice Address - Country:US
Practice Address - Phone:505-766-4800
Practice Address - Fax:505-898-5270
Is Sole Proprietor?:No
Enumeration Date:2006-03-09
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NMDD19851223X0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223X0400XDental ProvidersDentistOrthodontics and Dentofacial Orthopedics
Provider Identifiers
StateIdentifier IDID TypeIssuer
NM00066908Medicaid