Provider Demographics
NPI:1942421292
Name:QUIROS, DANIEL (DMD)
Entity Type:Individual
Prefix:DR
First Name:DANIEL
Middle Name:
Last Name:QUIROS
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 1:6195 STATE ROUTE 31
Mailing Address - Street 2:
Mailing Address - City:CICERO
Mailing Address - State:NY
Mailing Address - Zip Code:13039-9269
Mailing Address - Country:US
Mailing Address - Phone:315-698-6880
Mailing Address - Fax:
Practice Address - Street 1:6195 STATE ROUTE 31, SUITE 10
Practice Address - Street 2:CHOICE FAMILY DENTISTRY & DENTURES
Practice Address - City:CICERO
Practice Address - State:NY
Practice Address - Zip Code:13039
Practice Address - Country:US
Practice Address - Phone:315-698-6880
Practice Address - Fax:315-698-6886
Is Sole Proprietor?:No
Enumeration Date:2007-05-02
Last Update Date:2014-03-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY052381122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY02782685Medicaid