Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 122300000X | Dentist | 30.025838 | OH |
NPI | 1003475310 |
---|---|
Provider Name | Dr. Monica Torres |
First Address | Shaker Heights, OH 44120-5371 |
Second Address | Cleveland, OH 44128-2100 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 10/06/2019 |
Last Update Date | 14/06/2019 |