Provider Demographics
NPI:1952036154
Name:DANTONIO, QUINCY OLIVER (DMD)
Entity Type:Individual
Prefix:
First Name:QUINCY
Middle Name:OLIVER
Last Name:DANTONIO
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:PSC 466 BOX 3
Mailing Address - Street 2:
Mailing Address - City:FPO
Mailing Address - State:AP
Mailing Address - Zip Code:96595-0001
Mailing Address - Country:US
Mailing Address - Phone:243-370-4249
Mailing Address - Fax:
Practice Address - Street 1:PSC 466 BX3
Practice Address - Street 2:
Practice Address - City:FPO
Practice Address - State:AP
Practice Address - Zip Code:96595-0001
Practice Address - Country:US
Practice Address - Phone:401-374-4200
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2022-07-21
Last Update Date:2023-09-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
SC10226122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist