Provider Demographics
NPI:1033290663
Name:QUINN, JOHN TIMOTHY (DDS PS)
Entity Type:Individual
Prefix:DR
First Name:JOHN
Middle Name:TIMOTHY
Last Name:QUINN
Suffix:
Gender:M
Credentials:DDS PS
Other - Prefix:DR
Other - First Name:JOHN
Other - Middle Name:TIMOTHY
Other - Last Name:QUINN
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:DDS PS
Mailing Address - Street 1:5122 OLYMPIC DR NW B206
Mailing Address - Street 2:
Mailing Address - City:GIG HARBOR
Mailing Address - State:WA
Mailing Address - Zip Code:98335
Mailing Address - Country:US
Mailing Address - Phone:235-851-6789
Mailing Address - Fax:253-851-9558
Practice Address - Street 1:5122 OLYMPIC DR NW B206
Practice Address - Street 2:
Practice Address - City:GIG HARBOR
Practice Address - State:WA
Practice Address - Zip Code:98335
Practice Address - Country:US
Practice Address - Phone:235-851-6789
Practice Address - Fax:253-851-9558
Is Sole Proprietor?:No
Enumeration Date:2006-10-18
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WA5135122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist