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General NPI Number Information
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NPI Number | 1295896272
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Entity Type | Organization
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Legal Business Name | DANNY W QUALLIOTINE DDS PA
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Dates
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Enumeration Date | 12/13/2006
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Last Update Date | 08/22/2020
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Provider Practice Location Address
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Address Line | 107 OAKMONT DR
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City | GREENVILLE
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State | NC
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Zip | 27858
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Country | US
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Telephone | 252-321-2500
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Fax | 252-321-0248
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Provider Business Mailing Address
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Address Line | 107 OAKMONT DR
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City | GREENVILLE
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State | NC
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Zip | 27858
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Country | US
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Telephone | 252-321-2500
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Fax | 252-321-0248
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Authorized Official
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Title or Position | DENTIST PRESIDENTS
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Name | DR. DANNY W QUALLIOTINE
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Credential | DDS
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Telephone | 252-321-2500
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 122300000X
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Taxonomy Name | Dentist
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License Number | 4302
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License Number State | NC
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