Provider Demographics
NPI:1629103395
Name:TORRES, ANTHONY M (DDS)
Entity type:Individual
Prefix:DR
First Name:ANTHONY
Middle Name:M
Last Name:TORRES
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 1:3512 E FLORENCE AVE STE 204
Mailing Address - Street 2:
Mailing Address - City:HUNTINGTON PARK
Mailing Address - State:CA
Mailing Address - Zip Code:90255-5900
Mailing Address - Country:US
Mailing Address - Phone:323-589-6765
Mailing Address - Fax:
Practice Address - Street 1:3512 E FLORENCE AVE STE 204
Practice Address - Street 2:
Practice Address - City:HUNTINGTON PARK
Practice Address - State:CA
Practice Address - Zip Code:90255-5900
Practice Address - Country:US
Practice Address - Phone:323-589-6765
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2007-02-22
Last Update Date:2022-05-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA336781223S0112X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223S0112XDental ProvidersDentistOral and Maxillofacial Surgery
Provider Identifiers
StateIdentifier IDID TypeIssuer
CAB33678-01OtherDENTI-CAL PROVIDER NUMBER