Provider Demographics
NPI:1962539197
Name:QUARTERMAN, ROBBIN J (DMD)
Entity type:Individual
Prefix:
First Name:ROBBIN
Middle Name:J
Last Name:QUARTERMAN
Suffix:
Gender:F
Credentials:DMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:244 N FREDERICK AVE
Mailing Address - Street 2:
Mailing Address - City:DAYTONA BEACH
Mailing Address - State:FL
Mailing Address - Zip Code:32114-3408
Mailing Address - Country:US
Mailing Address - Phone:386-255-0238
Mailing Address - Fax:386-255-5566
Practice Address - Street 1:244 N FREDERICK AVE
Practice Address - Street 2:
Practice Address - City:DAYTONA BEACH
Practice Address - State:FL
Practice Address - Zip Code:32114-3408
Practice Address - Country:US
Practice Address - Phone:386-255-0238
Practice Address - Fax:386-255-5566
Is Sole Proprietor?:No
Enumeration Date:2007-02-27
Last Update Date:2012-12-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLDN00098961223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL077539896Medicaid
FL077539800Medicaid