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General NPI Number Information
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NPI Number | 1063088581
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Entity Type | Individual
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Provider Name | JOHN-VINCENT QUIAO DDS
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Gender | Male
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Dates
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Enumeration Date | 06/03/2021
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Last Update Date | 07/12/2024
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Provider Practice Location Address
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Address Line | 122 PROFESSIONAL VIEW DR BLDG 100
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City | FREEHOLD
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State | NJ
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Zip | 07728-7902
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Country | US
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Telephone | 732-625-8080
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Fax |
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Provider Business Mailing Address
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Address Line | 3861 BRIARHILL ST
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City | MOHEGAN LAKE
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State | NY
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Zip | 10547-1004
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Country | US
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Telephone | 914-434-1640
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 1223P0221X
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Taxonomy Name | Pediatric Dentistry
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License Number | 22DI02864800
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License Number State | NJ
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