Provider Demographics
NPI:1336244755
Name:QUINTO, MARLENE REY (DMD)
Entity Type:Individual
Prefix:DR
First Name:MARLENE
Middle Name:REY
Last Name:QUINTO
Suffix:
Gender:F
Credentials:DMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1557 E AMAR RD
Mailing Address - Street 2:SUITE C
Mailing Address - City:WEST COVINA
Mailing Address - State:CA
Mailing Address - Zip Code:91792-1678
Mailing Address - Country:US
Mailing Address - Phone:626-913-8548
Mailing Address - Fax:626-913-8598
Practice Address - Street 1:1557 E AMAR RD
Practice Address - Street 2:SUITE C
Practice Address - City:WEST COVINA
Practice Address - State:CA
Practice Address - Zip Code:91792-1678
Practice Address - Country:US
Practice Address - Phone:626-913-8548
Practice Address - Fax:626-913-8598
Is Sole Proprietor?:No
Enumeration Date:2006-09-13
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA378991223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice
Provider Identifiers
StateIdentifier IDID TypeIssuer
CA37899OtherLICENSENO.