Provider Demographics
NPI:1548611189
Name:QUINTERO, GEORGE (DDS)
Entity Type:Individual
Prefix:DR
First Name:GEORGE
Middle Name:
Last Name:QUINTERO
Suffix:
Gender:M
Credentials:DDS
Other - Prefix:MR
Other - First Name:JORGE
Other - Middle Name:
Other - Last Name:QUINTERO
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:
Mailing Address - Street 1:7326 LAKE UNDERHILL RD
Mailing Address - Street 2:
Mailing Address - City:ORLANDO
Mailing Address - State:FL
Mailing Address - Zip Code:32822-6055
Mailing Address - Country:US
Mailing Address - Phone:407-658-4060
Mailing Address - Fax:
Practice Address - Street 1:7326 LAKE UNDERHILL RD
Practice Address - Street 2:
Practice Address - City:ORLANDO
Practice Address - State:FL
Practice Address - Zip Code:32822-6055
Practice Address - Country:US
Practice Address - Phone:407-658-4060
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2016-06-24
Last Update Date:2016-06-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLDN 21905122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist