Provider Demographics
NPI:1306960893
Name:TORRES, JOSE R (DDS)
Entity type:Individual
Prefix:DR
First Name:JOSE
Middle Name:R
Last Name:TORRES
Suffix:
Gender:M
Credentials:DDS
Other - Prefix:
Other - First Name:
Other - Middle Name:
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Other - Credentials:
Mailing Address - Street 1:7622 BRUNACHE ST
Mailing Address - Street 2:
Mailing Address - City:DOWNEY
Mailing Address - State:CA
Mailing Address - Zip Code:90242-2204
Mailing Address - Country:US
Mailing Address - Phone:562-869-7951
Mailing Address - Fax:323-589-7448
Practice Address - Street 1:3619 SLAUSON AVE STE B
Practice Address - Street 2:
Practice Address - City:MAYWOOD
Practice Address - State:CA
Practice Address - Zip Code:90270-2631
Practice Address - Country:US
Practice Address - Phone:323-589-7440
Practice Address - Fax:323-589-7448
Is Sole Proprietor?:Yes
Enumeration Date:2007-03-19
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA49685122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist
Provider Identifiers
StateIdentifier IDID TypeIssuer
CAG-92337-01Medicare ID - Type Unspecified