Provider Demographics
NPI:1912712670
Name:GRISELDA CELIS-TORRUCO RDHAP A PROFESSIONAL CORPORATION
Entity type:Organization
Organization Name:GRISELDA CELIS-TORRUCO RDHAP A PROFESSIONAL CORPORATION
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:MRS
Authorized Official - First Name:GRISELDA
Authorized Official - Middle Name:
Authorized Official - Last Name:CELIS-TORRUCO
Authorized Official - Suffix:
Authorized Official - Credentials:RDHAP
Authorized Official - Phone:818-636-8061
Mailing Address - Street 1:27544 DIANE MARIE CIR
Mailing Address - Street 2:
Mailing Address - City:SANTA CLARITA
Mailing Address - State:CA
Mailing Address - Zip Code:91350-1779
Mailing Address - Country:US
Mailing Address - Phone:818-636-8061
Mailing Address - Fax:
Practice Address - Street 1:27544 DIANE MARIE CIR
Practice Address - Street 2:
Practice Address - City:SANTA CLARITA
Practice Address - State:CA
Practice Address - Zip Code:91350-1779
Practice Address - Country:US
Practice Address - Phone:818-636-8061
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2025-02-10
Last Update Date:2025-02-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes124Q00000XDental ProvidersDental HygienistGroup - Single Specialty