Provider Demographics
NPI:1780969089
Name:QUINONES, LUIS ALBERTO (DMD)
Entity type:Individual
Prefix:DR
First Name:LUIS
Middle Name:ALBERTO
Last Name:QUINONES
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:RIO HONDO # 3
Mailing Address - Street 2:CEIBA CC-39
Mailing Address - City:BAYAMON
Mailing Address - State:PR
Mailing Address - Zip Code:00961-3106
Mailing Address - Country:US
Mailing Address - Phone:787-368-0744
Mailing Address - Fax:
Practice Address - Street 1:CARRETERA 181 KILOMETRO 8.5
Practice Address - Street 2:
Practice Address - City:TRUJILLO ALTO
Practice Address - State:PR
Practice Address - Zip Code:00976
Practice Address - Country:US
Practice Address - Phone:787-760-4890
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2011-10-18
Last Update Date:2011-10-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PR28721223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice