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General NPI Number Information
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NPI Number | 1154734150
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Entity Type | Organization
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Legal Business Name | KHUE QUAN, DDS, INC
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Dates
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Enumeration Date | 06/06/2014
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Last Update Date | 06/06/2014
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Provider Practice Location Address
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Address Line | 14571 MAGNOLIA ST STE 202
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City | WESTMINSTER
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State | CA
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Zip | 92683-5576
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Country | US
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Telephone | 714-897-9985
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Fax | 714-897-9989
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Provider Business Mailing Address
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Address Line | 14571 MAGNOLIA ST STE 202
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City | WESTMINSTER
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State | CA
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Zip | 92683-5576
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Country | US
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Telephone | 714-897-9985
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Fax |
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Authorized Official
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Title or Position | PRESIDENT
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Name | DR. KHUE QUAN
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Credential | DDS
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Telephone | 714-897-9985
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 1223G0001X
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Taxonomy Name | General Practice Dentistry
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License Number | 41466
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License Number State | CA
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