Individual
LIANA DE LA TORRE
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
7633 E JEFFERSON AVE STE 70, DETROIT, MI 48214-3730
(860) 840-6007
Mailing address
1778 W 75TH ST, HIALEAH, FL 33014-3737
(860) 840-6007
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
2901600580
MI
390200000X
Student in an Organized Health Care Education/Training Program
—
—
Other
Enumeration date
03/25/2020
Last updated
11/18/2020
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