Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 1223G0001X | General Practice | DN014073 | GA |
N | 213EG0000X | General Practice | DN014073 | GA |
Y | 1223P0300X | Periodontist | DN014073 | GA |
NPI | 1053622712 |
---|---|
Provider Name | Dr. David George Quintero |
First Address | Dacula, GA 30019-1664 |
Second Address | Dacula, GA 30019-1664 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 28/06/2010 |
Last Update Date | 07/01/2022 |