Individual
MARIA CONSTANZA TORRES IBACACHE
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
DDS
Contact information
Practice address
1 KNEELAND ST FL 2, BOSTON, MA 02111-1527
(617) 636-6828
Mailing address
1 CANAL ST UNIT 535, BOSTON, MA 02114-2027
(857) 389-5778
Taxonomy
Speciality
Code
Description
License number
State
122300000X
Dentist
DF11579
MA
122300000X
Dentist
Primary
DF11761
MA
390200000X
Student in an Organized Health Care Education/Training Program
—
—
Other
Enumeration date
07/08/2017
Last updated
11/04/2021
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