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General NPI Number Information
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NPI Number | 1306299987
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Entity Type | Organization
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Legal Business Name | JORGE E. QUINTERO
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Dates
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Enumeration Date | 07/19/2016
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Last Update Date | 07/19/2016
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Provider Practice Location Address
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Address Line | 7326 LAKE UNDERHILL RD
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City | ORLANDO
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State | FL
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Zip | 32822-6055
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Country | US
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Telephone | 407-658-4060
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Fax | 407-658-4062
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Provider Business Mailing Address
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Address Line | 7326 LAKE UNDERHILL RD
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City | ORLANDO
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State | FL
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Zip | 32822-6055
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Country | US
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Telephone | 407-658-4060
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Fax | 407-658-4062
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Authorized Official
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Title or Position | OFFICE MANAGER
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Name | MR. HECTOR LEON
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Credential |
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Telephone | 407-658-4060
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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 | DN18459
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License Number State | FL
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