Provider Demographics
NPI:1992522122
Name:BRAULIO, IZABELLA TORRES (DDS)
Entity type:Individual
Prefix:DR
First Name:IZABELLA TORRES
Middle Name:
Last Name:BRAULIO
Suffix:
Gender:F
Credentials:DDS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3140 SAWTELLE BLVD APT 203
Mailing Address - Street 2:
Mailing Address - City:LOS ANGELES
Mailing Address - State:CA
Mailing Address - Zip Code:90066-1440
Mailing Address - Country:US
Mailing Address - Phone:862-704-5545
Mailing Address - Fax:
Practice Address - Street 1:3140 SAWTELLE BLVD APT 203
Practice Address - Street 2:
Practice Address - City:LOS ANGELES
Practice Address - State:CA
Practice Address - Zip Code:90066-1440
Practice Address - Country:US
Practice Address - Phone:862-704-5545
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2024-09-19
Last Update Date:2024-09-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA1108091223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice