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General NPI Number Information
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NPI Number | 1366815276
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Entity Type | Organization
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Legal Business Name | QUINN DENTAL, INC
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Dates
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Enumeration Date | 11/02/2015
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Last Update Date | 11/02/2015
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Provider Practice Location Address
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Address Line | 2119 E MAIN ST
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City | TORRINGTON
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State | CT
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Zip | 06790-3106
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Country | US
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Telephone | 860-482-4041
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Fax | 860-482-2471
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Provider Business Mailing Address
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Address Line | 2119 E MAIN ST
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City | TORRINGTON
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State | CT
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Zip | 06790-3106
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Country | US
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Telephone | 860-482-4041
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Fax | 860-482-2471
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Authorized Official
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Title or Position | PRESIDENT
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Name | ONIKA QUINN-MUNROE
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Credential | DMD
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Telephone | 860-482-4041
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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 | 11411
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License Number State | CT
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