Individual
DR. YANDRESCO QUINTANA
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
DDS, MD
Contact information
Practice address
651 W 180TH ST STE 1, NEW YORK, NY 10033-4802
(212) 927-0565
(212) 812-3239
Mailing address
651 W 180TH ST STE 1, NEW YORK, NY 10033-4802
(212) 927-0565
Taxonomy
Speciality
Code
Description
License number
State
1223S0112X
Oral and Maxillofacial Surgery (Dentist)
Primary
057383
NY
204E00000X
Oral & Maxillofacial Surgery (D.M.D.)
276236
NY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
04345231
—
NY
Enumeration date
06/16/2008
Last updated
09/21/2020
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