Provider Demographics
NPI:1649152471
Name:PAGE QUATTLEBAUM & ASSOCIATES LLC
Entity type:Organization
Organization Name:PAGE QUATTLEBAUM & ASSOCIATES LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:MANAGING MEMBER
Authorized Official - Prefix:DR
Authorized Official - First Name:GREGORY
Authorized Official - Middle Name:
Authorized Official - Last Name:QUATTLEBAUM
Authorized Official - Suffix:
Authorized Official - Credentials:DMD
Authorized Official - Phone:239-263-2122
Mailing Address - Street 1:4953 CASTELLO DRIVE
Mailing Address - Street 2:UNIT 100
Mailing Address - City:NAPLES
Mailing Address - State:FL
Mailing Address - Zip Code:34103
Mailing Address - Country:US
Mailing Address - Phone:239-263-2122
Mailing Address - Fax:239-263-2122
Practice Address - Street 1:4953 CASTELLO DRIVE
Practice Address - Street 2:UNIT 100
Practice Address - City:NAPLES
Practice Address - State:FL
Practice Address - Zip Code:34103
Practice Address - Country:US
Practice Address - Phone:239-263-2122
Practice Address - Fax:239-263-2122
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2025-07-23
Last Update Date:2025-07-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes122300000XDental ProvidersDentistGroup - Single Specialty