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General NPI Number Information
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NPI Number | 1083492664
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Entity Type | Organization
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Legal Business Name | QUINTERO FAMILY DENTAL, LLC
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Dates
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Enumeration Date | 09/15/2023
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Last Update Date | 09/15/2023
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Provider Practice Location Address
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Address Line | 547 EAST BRANNON RD
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City | NICHOLASVILLE
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State | KY
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Zip | 40356
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Country | US
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Telephone | 407-718-8553
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Fax |
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Provider Business Mailing Address
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Address Line | 3193 BRIGHTON PLACE DR
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City | LEXINGTON
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State | KY
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Zip | 40509-2371
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Country | US
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Telephone | 407-718-8553
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Fax |
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Authorized Official
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Title or Position | OWNER/DENTIST
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Name | DR. GEORGE QUINTERO
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Credential | DMD
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Telephone | 407-718-8553
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 1223G0001X
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Taxonomy Name | General Practice Dentistry
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License Number |
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License Number State |
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