Provider Demographics
NPI:1689788689
Name:QUINTANO, ROBERT (DDS)
Entity Type:Individual
Prefix:DR
First Name:ROBERT
Middle Name:
Last Name:QUINTANO
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 1:46 OCEAN ST
Mailing Address - Street 2:
Mailing Address - City:BELFAST
Mailing Address - State:ME
Mailing Address - Zip Code:04915-6745
Mailing Address - Country:US
Mailing Address - Phone:910-393-8209
Mailing Address - Fax:
Practice Address - Street 1:125 NORTHPORT AVE
Practice Address - Street 2:SUITE 107
Practice Address - City:BELFAST
Practice Address - State:ME
Practice Address - Zip Code:04915-6002
Practice Address - Country:US
Practice Address - Phone:207-338-9307
Practice Address - Fax:207-338-9331
Is Sole Proprietor?:Yes
Enumeration Date:2006-08-18
Last Update Date:2014-11-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC6083122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist
Provider Identifiers
StateIdentifier IDID TypeIssuer
760649708OtherTAX ID