MEDICARE: KEVIN W. QUINN, DMD, P.C.

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	1223P0300X	Periodontics	20490	MA

General Provider Information

NPI Number	:	1093118747
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	KEVIN W. QUINN, DMD, P.C.

Provider Business Mailing Address
First Line	:	74 FAUNCE CORNER RD
Second Line	:	SUITE 620
City	:	N DARTMOUTH
State	:	MA
Zip	:	02747-1209
Country	:	US
Telephone Number	:	508-997-2999
Fax Number	:	508-997-5099

Provider Business Practice Location Address
First Line	:	74 FAUNCE CORNER RD
Second Line	:	SUITE 620
City	:	N DARTMOUTH
State	:	MA
Zip	:	02747-1209
Country	:	US
Telephone Number	:	508-997-2999
Fax Number	:	508-997-5099

Authorized Official
Title or Position	:	DOCTOR
Name	:	DR. KEVIN W QUINN
Credential	:
Telephone Number	:	508-997-2999

Provider Enumeration Date	:	10/08/2014
Last Update Date	:	10/08/2014

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