Provider Demographics
NPI:1639242282
Name:QUINTANA ALBERTORIO, NELSON (DMD)
Entity Type:Individual
Prefix:DR
First Name:NELSON
Middle Name:
Last Name:QUINTANA ALBERTORIO
Suffix:
Gender:M
Credentials:DMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1965 AVE LAS AMERICAS
Mailing Address - Street 2:
Mailing Address - City:PONCE
Mailing Address - State:PR
Mailing Address - Zip Code:00728-1815
Mailing Address - Country:US
Mailing Address - Phone:787-284-1313
Mailing Address - Fax:787-284-1515
Practice Address - Street 1:1965 AVE LAS AMERICAS
Practice Address - Street 2:
Practice Address - City:PONCE
Practice Address - State:PR
Practice Address - Zip Code:00728-1815
Practice Address - Country:US
Practice Address - Phone:787-284-1313
Practice Address - Fax:787-284-1515
Is Sole Proprietor?:Yes
Enumeration Date:2006-11-15
Last Update Date:2013-03-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PR2044122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist