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NPI Code Detail

MEDICARE: SUSAN WINGFIELD QUINTANA RDH

MEDICARE:   SUSAN WINGFIELD QUINTANA  RDH
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
1124Q00000XDental Hygienist11507TX

General Provider Information

NPI Number : 1730765132
Entity Type Code : Individual
Provider Name (Legal Business Name) : SUSAN WINGFIELD QUINTANA RDH
Provider Business Mailing Address
First Line : 5918 4TH ST
Second Line :
City : KATY
State : TX
Zip : 77493-2445
Country : US
Telephone Number : 832-452-9441
Fax Number :
Provider Business Practice Location Address
First Line : 5918 4TH ST
Second Line :
City : KATY
State : TX
Zip : 77493-2445
Country : US
Telephone Number : 832-452-9441
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 03/24/2021
Last Update Date : 03/29/2021

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Directions to “ SUSAN WINGFIELD QUINTANA RDH” Practice Location

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