Healthcare Provider Details

I. General information

NPI: 1346496023
Provider Name (Legal Business Name): OSCAR C. QUINTANA DDS,PC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 08/13/2008
Last Update Date: 08/13/2008
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

8501 CANDELARIA RD NE STE C
ALBUQUERQUE NM
87112-1034
US

IV. Provider business mailing address

8501 CANDELARIA RD NE STE C
ALBUQUERQUE NM
87112-1034
US

V. Phone/Fax

Practice location:
  • Phone: 505-292-8300
  • Fax: 505-332-4335
Mailing address:
  • Phone: 505-292-8300
  • Fax: 505-332-4335

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code332BC3200X
TaxonomyCustomized Equipment (DME)
License Number1513
License Number StateNM

VIII. Authorized Official

Name: MRS. VICKI PISOTTI
Title or Position: OFFICE MANAGER
Credential:
Phone: 505-292-1582