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General NPI Number Information
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NPI Number | 1629108857
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Entity Type | Organization
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Legal Business Name | QUEST JOHNSON ORTHODONTICS, PC
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Dates
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Enumeration Date | 03/06/2007
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Last Update Date | 08/22/2020
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Provider Practice Location Address
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Address Line | 203 N INDIANA ST
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City | MOORESVILLE
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State | IN
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Zip | 46158-1508
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Country | US
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Telephone | 317-834-4933
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Fax | 317-834-4935
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Provider Business Mailing Address
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Address Line | 203 N INDIANA ST
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City | MOORESVILLE
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State | IN
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Zip | 46158-1508
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Country | US
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Telephone | 317-834-4933
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Fax | 317-834-4935
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Authorized Official
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Title or Position | PRESIDENT
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Name | DR. WILLIAM JOSEPH QUEST
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Credential | DDS, MS
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Telephone | 317-834-4933
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 1223X0400X
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Taxonomy Name | Orthodontics and Dentofacial Orthopedics Dentistry
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License Number | 12008607A
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License Number State | IN
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