Individual
VALERIA LABASTIDA TORRES
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
1955 N COBB PKWY STE 110, KENNESAW, GA 30152-4503
(770) 799-8964
Mailing address
1720 WAVERLY CV, ALPHARETTA, GA 30004-0669
(817) 734-6025
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
DN122614
GA
390200000X
Student in an Organized Health Care Education/Training Program
—
—
Other
Enumeration date
10/27/2020
Last updated
06/12/2022
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