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NPI Code Detail

MEDICARE: DR. QUINTIN DAVID RUPP DDS

MEDICARE:  DR. QUINTIN DAVID RUPP  DDS
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
11223G0001XGeneral Practice Dentistry26453TX

General Provider Information

NPI Number : 1609178177
Entity Type Code : Individual
Provider Name (Legal Business Name) : DR. QUINTIN DAVID RUPP DDS
Provider Business Mailing Address
First Line : 12215 RAW SILVER
Second Line :
City : SAN ANTONIO
State : TX
Zip : 78254-5787
Country : US
Telephone Number : 435-224-3294
Fax Number :
Provider Business Practice Location Address
First Line : 5531 W LOOP 1604 N STE 115
Second Line :
City : SAN ANTONIO
State : TX
Zip : 78253-7305
Country : US
Telephone Number : 210-293-0696
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 12/03/2010
Last Update Date : 09/07/2011

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Directions to “ DR. QUINTIN DAVID RUPP DDS” Practice Location

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