MEDICARE: QUINTANA DENTISTRY LLC

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	122300000X	Dentist

General Provider Information

NPI Number	:	1538026232
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	QUINTANA DENTISTRY LLC

Provider Business Mailing Address
First Line	:	2-26 CALLE 5
Second Line	:
City	:	CAROLINA
State	:	PR
Zip	:	00983-2934
Country	:	US
Telephone Number	:	787-518-0816
Fax Number	:

Provider Business Practice Location Address
First Line	:	456 CALLE CESAR GONZALEZ
Second Line	:
City	:	SAN JUAN
State	:	PR
Zip	:	00918-2628
Country	:	US
Telephone Number	:	787-753-2376
Fax Number	:

Authorized Official
Title or Position	:	DENTIST
Name	:	DR. ANGEL ELLIUD QUINTANA CRUZ
Credential	:	DMD
Telephone Number	:	787-518-0816

Provider Enumeration Date	:	01/06/2026
Last Update Date	:	01/06/2026

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