Provider Demographics
NPI:1093482796
Name:ELVIA A. QUINTERO S.
Entity Type:Organization
Organization Name:ELVIA A. QUINTERO S.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:ELVIA
Authorized Official - Middle Name:ARACELI
Authorized Official - Last Name:QUINTERO S.
Authorized Official - Suffix:
Authorized Official - Credentials:DDS
Authorized Official - Phone:664-378-7135
Mailing Address - Street 1:10459 LOMA RANCHO DR.
Mailing Address - Street 2:
Mailing Address - City:SPRING VALLEY
Mailing Address - State:CA
Mailing Address - Zip Code:91978
Mailing Address - Country:US
Mailing Address - Phone:664-378-7135
Mailing Address - Fax:858-430-3143
Practice Address - Street 1:PASEO DE LOS ALAMOS 914940B
Practice Address - Street 2:FRACC. EL REFUGIO
Practice Address - City:TIJUANA
Practice Address - State:CA
Practice Address - Zip Code:22243
Practice Address - Country:US
Practice Address - Phone:664-378-7135
Practice Address - Fax:858-430-3143
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2021-08-30
Last Update Date:2021-08-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1223G0001XDental ProvidersDentistGeneral PracticeGroup - Multi-Specialty