Individual
ARIADNA ALICIA TORRES-GORENA
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
DDS, MSD
Contact information
Practice address
690 NORTH ROUTE 31, CRYSTAL LAKE, IL 60012
(815) 325-0208
Mailing address
5506 RENEE AVE, CRYSTAL LAKE, IL 60014-3873
(815) 325-0208
Taxonomy
Speciality
Code
Description
License number
State
1223X0400X
Orthodontics and Dentofacial Orthopedics Dentistry
Primary
019029396
IL
Other
Enumeration date
08/22/2014
Last updated
08/22/2014
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