Provider Demographics
NPI:1144717240
Name:QUINTANAL, OVY (DDS, MDS)
Entity type:Individual
Prefix:
First Name:OVY
Middle Name:
Last Name:QUINTANAL
Suffix:
Gender:M
Credentials:DDS, MDS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:421 SW 58TH AVE
Mailing Address - Street 2:
Mailing Address - City:PLANTATION
Mailing Address - State:FL
Mailing Address - Zip Code:33317-3553
Mailing Address - Country:US
Mailing Address - Phone:305-951-0850
Mailing Address - Fax:
Practice Address - Street 1:2300 NE 9TH ST
Practice Address - Street 2:
Practice Address - City:FORT LAUDERDALE
Practice Address - State:FL
Practice Address - Zip Code:33304-3587
Practice Address - Country:US
Practice Address - Phone:954-737-2300
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2018-04-16
Last Update Date:2023-11-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLDN23828122300000X, 1223X0400X
TN10693122300000X, 1223X0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223X0400XDental ProvidersDentistOrthodontics and Dentofacial Orthopedics
No122300000XDental ProvidersDentist