Provider Demographics
NPI:1306433065
Name:DR QUESADA & ASSOCIATES PA
Entity type:Organization
Organization Name:DR QUESADA & ASSOCIATES PA
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER/LEADING DENTIST
Authorized Official - Prefix:DR
Authorized Official - First Name:PEDRO
Authorized Official - Middle Name:
Authorized Official - Last Name:QUESADA
Authorized Official - Suffix:
Authorized Official - Credentials:DDS
Authorized Official - Phone:786-231-9259
Mailing Address - Street 1:6267 W SAMPLE RD
Mailing Address - Street 2:
Mailing Address - City:CORAL SPRINGS
Mailing Address - State:FL
Mailing Address - Zip Code:33067-3175
Mailing Address - Country:US
Mailing Address - Phone:954-341-4766
Mailing Address - Fax:954-255-8131
Practice Address - Street 1:6267 W SAMPLE RD
Practice Address - Street 2:
Practice Address - City:CORAL SPRINGS
Practice Address - State:FL
Practice Address - Zip Code:33067-3175
Practice Address - Country:US
Practice Address - Phone:954-341-4766
Practice Address - Fax:954-255-8131
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2020-12-29
Last Update Date:2020-12-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QD0000XAmbulatory Health Care FacilitiesClinic/CenterDental