Provider Demographics
NPI:1376049197
Name:VICTOR J QUANT DDS INC
Entity Type:Organization
Organization Name:VICTOR J QUANT DDS INC
Other - Org Name:MISSION DENTAL HEALTH
Other - Org Type:Doing Business As
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:VICTOR
Authorized Official - Middle Name:JOAQUIN
Authorized Official - Last Name:QUANT
Authorized Official - Suffix:
Authorized Official - Credentials:DDS
Authorized Official - Phone:415-824-2292
Mailing Address - Street 1:2725 MISSION ST
Mailing Address - Street 2:
Mailing Address - City:SAN FRANCISCO
Mailing Address - State:CA
Mailing Address - Zip Code:94110-3103
Mailing Address - Country:US
Mailing Address - Phone:415-824-2292
Mailing Address - Fax:415-821-7978
Practice Address - Street 1:2725 MISSION ST
Practice Address - Street 2:
Practice Address - City:SAN FRANCISCO
Practice Address - State:CA
Practice Address - Zip Code:94110-3103
Practice Address - Country:US
Practice Address - Phone:415-824-2292
Practice Address - Fax:415-821-7978
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2018-04-02
Last Update Date:2018-04-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA60874261QD0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QD0000XAmbulatory Health Care FacilitiesClinic/CenterDental