Provider Demographics
NPI:1871597302
Name:QUINONES, GERARDO DAVID (DMD)
Entity type:Individual
Prefix:DR
First Name:GERARDO
Middle Name:DAVID
Last Name:QUINONES
Suffix:
Gender:M
Credentials:DMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:136 KESSLER LN
Mailing Address - Street 2:
Mailing Address - City:BEEVILLE
Mailing Address - State:TX
Mailing Address - Zip Code:78102-8409
Mailing Address - Country:US
Mailing Address - Phone:520-425-5058
Mailing Address - Fax:361-358-9787
Practice Address - Street 1:1703 N SAINT MARYS ST
Practice Address - Street 2:
Practice Address - City:BEEVILLE
Practice Address - State:TX
Practice Address - Zip Code:78102-2738
Practice Address - Country:US
Practice Address - Phone:361-358-9780
Practice Address - Fax:361-358-9787
Is Sole Proprietor?:Yes
Enumeration Date:2005-06-13
Last Update Date:2021-05-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OK63461223G0001X
PR14361223G0001X
TX287621223G0001X
AZD71961223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice