Provider Demographics
NPI:1346395118
Name:CUARTO, VALENTIN III (DDS)
Entity Type:Individual
Prefix:
First Name:VALENTIN
Middle Name:
Last Name:CUARTO
Suffix:III
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 1:1519 S CANDLESTICK WAY
Mailing Address - Street 2:
Mailing Address - City:WAUKEGAN
Mailing Address - State:IL
Mailing Address - Zip Code:60085-8648
Mailing Address - Country:US
Mailing Address - Phone:847-360-0599
Mailing Address - Fax:
Practice Address - Street 1:27620 75TH ST
Practice Address - Street 2:SUITE 3
Practice Address - City:SALEM
Practice Address - State:WI
Practice Address - Zip Code:53168-9530
Practice Address - Country:US
Practice Address - Phone:262-843-1808
Practice Address - Fax:262-843-1908
Is Sole Proprietor?:Yes
Enumeration Date:2007-01-24
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WI52201223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice