Provider Demographics
NPI:1003030404
Name:QUINN YU DDS INC
Entity Type:Organization
Organization Name:QUINN YU DDS INC
Other - Org Name:WEST COAST DENTAL GROUP OF RIVERSIDE
Other - Org Type:Doing Business As
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:QUINN
Authorized Official - Middle Name:
Authorized Official - Last Name:YU
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:951-354-9999
Mailing Address - Street 1:3380 LA SIERRA AVE
Mailing Address - Street 2:SUITE 108,109,110
Mailing Address - City:RIVERSIDE
Mailing Address - State:CA
Mailing Address - Zip Code:92503
Mailing Address - Country:US
Mailing Address - Phone:951-354-9999
Mailing Address - Fax:951-354-6666
Practice Address - Street 1:3380 LA SIERRA AVE
Practice Address - Street 2:SUITE 108,109,110
Practice Address - City:RIVERSIDE
Practice Address - State:CA
Practice Address - Zip Code:92503
Practice Address - Country:US
Practice Address - Phone:951-354-9999
Practice Address - Fax:951-354-6666
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:WEST COAST DENTAL
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2007-04-13
Last Update Date:2010-01-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA486981223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1223G0001XDental ProvidersDentistGeneral PracticeGroup - Single Specialty