Healthcare Provider Details

I. General information

NPI: 1578651352
Provider Name (Legal Business Name): DANIEL T MCQUINN DMD
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 10/10/2006
Last Update Date: 07/08/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

760 WICKS LANE
BILLINGS MT
59105
US

IV. Provider business mailing address

760 WICKS LANE SUITE 4
BILLINGS MT
59105
US

V. Phone/Fax

Practice location:
  • Phone: 406-657-8000
  • Fax:
Mailing address:
  • Phone: 406-657-8000
  • Fax: 406-657-6576

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1223X0400X
TaxonomyOrthodontics and Dentofacial Orthopedics Dentistry
License Number1746
License Number StateMT

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: