Provider Demographics
NPI:1871720821
Name:QUARTANO, ROSS WEBSTER (DDS)
Entity type:Individual
Prefix:DR
First Name:ROSS
Middle Name:WEBSTER
Last Name:QUARTANO
Suffix:
Gender:M
Credentials:DDS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1204 RUE DEGAS
Mailing Address - Street 2:
Mailing Address - City:MANDEVILLE
Mailing Address - State:LA
Mailing Address - Zip Code:70471-3056
Mailing Address - Country:US
Mailing Address - Phone:985-626-3348
Mailing Address - Fax:
Practice Address - Street 1:1204 RUE DEGAS
Practice Address - Street 2:
Practice Address - City:MANDEVILLE
Practice Address - State:LA
Practice Address - Zip Code:70471-3056
Practice Address - Country:US
Practice Address - Phone:985-626-3348
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2009-06-17
Last Update Date:2013-04-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
LA59791223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice