Provider Demographics
NPI:1548926728
Name:TORRES, DIANA (RDH)
Entity type:Individual
Prefix:MRS
First Name:DIANA
Middle Name:
Last Name:TORRES
Suffix:
Gender:F
Credentials:RDH
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 13024
Mailing Address - Street 2:
Mailing Address - City:SAN DIEGO
Mailing Address - State:CA
Mailing Address - Zip Code:92170-3024
Mailing Address - Country:US
Mailing Address - Phone:224-730-1726
Mailing Address - Fax:
Practice Address - Street 1:USS MAKIN ISLAND LHD8
Practice Address - Street 2:UNIT 100222
Practice Address - City:FPO
Practice Address - State:AP
Practice Address - Zip Code:96672-9667
Practice Address - Country:US
Practice Address - Phone:224-730-1726
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2021-11-12
Last Update Date:2021-11-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FL29008124Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes124Q00000XDental ProvidersDental Hygienist