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General NPI Number Information
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NPI Number | 1205848090
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Entity Type | Individual
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Provider Name | KAYLEEN MICHELLE QUINN D.M.D.
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Gender | Female
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Dates
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Enumeration Date | 08/12/2006
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Last Update Date | 07/08/2007
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Provider Practice Location Address
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Address Line | 430 SE 17TH ST
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City | OCALA
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State | FL
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Zip | 34471-4433
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Country | US
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Telephone | 352-732-3425
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Fax | 352-732-4140
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Provider Business Mailing Address
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Address Line | 5333 SW 75TH ST APT S106
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City | GAINESVILLE
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State | FL
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Zip | 32608-7451
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Country | US
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Telephone | 352-682-4683
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 122300000X
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Taxonomy Name | Dentist
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License Number | DL17716
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License Number State | FL
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