Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 1223P0700X | Prosthodontist | 14803 | TX |
NPI | 1073523510 |
---|---|
Provider Name | Dr. Edgardo Emilio Quinones |
First Address | Dallas, TX 75205-1906 |
Second Address | Dallas, TX 75216-7167 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 08/08/2006 |
Last Update Date | 08/07/2007 |