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General NPI Number Information
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NPI Number | 1902280977
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Entity Type | Individual
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Provider Name | ALICIA CASAREZ-QUINTANA D.D.S
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Gender | Female
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Dates
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Enumeration Date | 07/19/2015
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Last Update Date | 01/03/2025
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Provider Practice Location Address
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Address Line | 8210 FLOYD CURL DRIVE, MSC 8103 UT HEALTH SCIENCE CENTER AT SAN ANTONIO
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City | SAN ANTONIO
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State | TX
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Zip | 78229
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Country | US
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Telephone | 210-450-3273
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Fax | 210-450-2223
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Provider Business Mailing Address
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Address Line | 8501 CANDELARIA RD NE STE C
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City | ALBUQUERQUE
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State | NM
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Zip | 87112-1032
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Country | US
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Telephone | 505-292-8300
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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 | 1223G0001X
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Taxonomy Name | General Practice Dentistry
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License Number | DD4437
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License Number State | NM
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Taxonomy #2
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Taxonomy Code | 390200000X
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Taxonomy Name | Student in an Organized Health Care Education/Training Program
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License Number | ETN357
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License Number State | NM
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Taxonomy #3
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Taxonomy Code | 1223P0300X
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Taxonomy Name | Periodontics
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License Number | 31092
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License Number State | TX
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