Provider Demographics
NPI:1124375639
Name:CUARTAS, ANDRES (DDS)
Entity Type:Individual
Prefix:
First Name:ANDRES
Middle Name:
Last Name:CUARTAS
Suffix:
Gender:M
Credentials:DDS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2913 NW 97TH CT
Mailing Address - Street 2:
Mailing Address - City:DORAL
Mailing Address - State:FL
Mailing Address - Zip Code:33172-1085
Mailing Address - Country:US
Mailing Address - Phone:305-882-9260
Mailing Address - Fax:
Practice Address - Street 1:2100 NW 107TH AVE # 106
Practice Address - Street 2:
Practice Address - City:SWEETWATER
Practice Address - State:FL
Practice Address - Zip Code:33172-2510
Practice Address - Country:US
Practice Address - Phone:305-882-9260
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2012-08-14
Last Update Date:2018-10-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLDN21040122300000X, 122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist