Provider Demographics
NPI:1760808356
Name:QUINTERO, RAFAEL ALBERTO (DDS)
Entity Type:Individual
Prefix:DR
First Name:RAFAEL
Middle Name:ALBERTO
Last Name:QUINTERO
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 1:3714 ATLANTIC AVE
Mailing Address - Street 2:
Mailing Address - City:LONG BEACH
Mailing Address - State:CA
Mailing Address - Zip Code:90807-3409
Mailing Address - Country:US
Mailing Address - Phone:949-861-0123
Mailing Address - Fax:
Practice Address - Street 1:3714 ATLANTIC AVE
Practice Address - Street 2:
Practice Address - City:LONG BEACH
Practice Address - State:CA
Practice Address - Zip Code:90807-3409
Practice Address - Country:US
Practice Address - Phone:949-861-0123
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2014-03-06
Last Update Date:2014-03-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA63160122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist