Provider Demographics
NPI:1205832052
Name:LINDQUIST, DEAN CARROLL (DDS)
Entity Type:Individual
Prefix:
First Name:DEAN
Middle Name:CARROLL
Last Name:LINDQUIST
Suffix:
Gender:M
Credentials:DDS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 588
Mailing Address - Street 2:
Mailing Address - City:RENVILLE
Mailing Address - State:MN
Mailing Address - Zip Code:56284-0588
Mailing Address - Country:US
Mailing Address - Phone:320-329-8321
Mailing Address - Fax:320-329-8322
Practice Address - Street 1:107 DUPONT AVE
Practice Address - Street 2:
Practice Address - City:RENVILLE
Practice Address - State:MN
Practice Address - Zip Code:56284-0588
Practice Address - Country:US
Practice Address - Phone:320-329-8321
Practice Address - Fax:320-329-8322
Is Sole Proprietor?:No
Enumeration Date:2005-06-27
Last Update Date:2007-07-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MN82831223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice