Provider Demographics
NPI:1972674448
Name:QUASHA, MICHAEL D (DMD)
Entity type:Individual
Prefix:DR
First Name:MICHAEL
Middle Name:D
Last Name:QUASHA
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 1:4520 DONALD ROSS RD
Mailing Address - Street 2:SUITE 105
Mailing Address - City:PALM BEACH GARDENS
Mailing Address - State:FL
Mailing Address - Zip Code:33418-5105
Mailing Address - Country:US
Mailing Address - Phone:561-799-5558
Mailing Address - Fax:561-799-9311
Practice Address - Street 1:4520 DONALD ROSS RD
Practice Address - Street 2:SUITE 105
Practice Address - City:PALM BEACH GARDENS
Practice Address - State:FL
Practice Address - Zip Code:33418-5105
Practice Address - Country:US
Practice Address - Phone:561-799-5558
Practice Address - Fax:561-799-9311
Is Sole Proprietor?:Yes
Enumeration Date:2006-11-13
Last Update Date:2009-04-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLDN160051223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice