Provider Demographics
NPI:1902960842
Name:QUINONES, ROSSELYN (DMD)
Entity Type:Individual
Prefix:DR
First Name:ROSSELYN
Middle Name:
Last Name:QUINONES
Suffix:
Gender:F
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:PO BOX 800159
Mailing Address - Street 2:
Mailing Address - City:COTO LAUREL
Mailing Address - State:PR
Mailing Address - Zip Code:00780-0159
Mailing Address - Country:US
Mailing Address - Phone:787-290-3165
Mailing Address - Fax:787-290-3191
Practice Address - Street 1:917 AVE TITO CASTRO
Practice Address - Street 2:HOSPITAL SAN LUCAS
Practice Address - City:PONCE
Practice Address - State:PR
Practice Address - Zip Code:00716-4717
Practice Address - Country:US
Practice Address - Phone:787-290-3165
Practice Address - Fax:787-290-3191
Is Sole Proprietor?:Yes
Enumeration Date:2006-12-21
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PR24301223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice