Provider Demographics
NPI:1942963780
Name:CAROL J QUINN DDS PC
Entity type:Organization
Organization Name:CAROL J QUINN DDS PC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:CAROL
Authorized Official - Middle Name:J
Authorized Official - Last Name:QUINN
Authorized Official - Suffix:
Authorized Official - Credentials:DDS
Authorized Official - Phone:313-881-1231
Mailing Address - Street 1:21024 MACK AVE
Mailing Address - Street 2:
Mailing Address - City:GROSSE POINTE WOODS
Mailing Address - State:MI
Mailing Address - Zip Code:48236-1334
Mailing Address - Country:US
Mailing Address - Phone:313-881-1231
Mailing Address - Fax:313-886-1122
Practice Address - Street 1:21024 MACK AVE
Practice Address - Street 2:
Practice Address - City:GROSSE POINTE WOODS
Practice Address - State:MI
Practice Address - Zip Code:48236-1334
Practice Address - Country:US
Practice Address - Phone:313-881-1231
Practice Address - Fax:313-886-1122
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2021-10-19
Last Update Date:2021-10-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QD0000XAmbulatory Health Care FacilitiesClinic/CenterDental