Healthcare Provider Details

I. General information

NPI: 1144520800
Provider Name (Legal Business Name): WILLIAM C. QUINLAN, D.D.S., P.C.
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 10/28/2010
Last Update Date: 10/28/2010
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

19535 MACK AVE
GROSSE POINTE WOODS MI
48236-2836
US

IV. Provider business mailing address

19535 MACK AVE
GROSSE POINTE WOODS MI
48236-2836
US

V. Phone/Fax

Practice location:
  • Phone: 313-881-4000
  • Fax: 313-881-2983
Mailing address:
  • Phone: 313-881-4000
  • Fax: 313-881-2983

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code122300000X
TaxonomyDentist
License Number9374
License Number StateMI

VIII. Authorized Official

Name: DR. WILLIAM C. QUINLAN
Title or Position: DENTIST
Credential: D.D.S.
Phone: 313-881-4000