Provider Demographics
NPI:1356376297
Name:QUINTIA, RONALD C (DDS)
Entity type:Individual
Prefix:DR
First Name:RONALD
Middle Name:C
Last Name:QUINTIA
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 1:6369 E TANQUE VERDE RD
Mailing Address - Street 2:SUITE 230
Mailing Address - City:TUCSON
Mailing Address - State:AZ
Mailing Address - Zip Code:85715-3850
Mailing Address - Country:US
Mailing Address - Phone:520-290-6800
Mailing Address - Fax:520-290-2270
Practice Address - Street 1:6369 E TANQUE VERDE RD
Practice Address - Street 2:SUITE 230
Practice Address - City:TUCSON
Practice Address - State:AZ
Practice Address - Zip Code:85715-3850
Practice Address - Country:US
Practice Address - Phone:520-290-6800
Practice Address - Fax:520-290-2270
Is Sole Proprietor?:Yes
Enumeration Date:2006-07-11
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AZD35391223S0112X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223S0112XDental ProvidersDentistOral and Maxillofacial Surgery
Provider Identifiers
StateIdentifier IDID TypeIssuer
AZDDS3539Medicare ID - Type Unspecified
AZT93523Medicare UPIN