Provider Demographics
NPI:1366507014
Name:QUIGLESS, KIRK (DDS)
Entity Type:Individual
Prefix:DR
First Name:KIRK
Middle Name:
Last Name:QUIGLESS
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 1:8083 MANCHESTER RD
Mailing Address - Street 2:
Mailing Address - City:BRENTWOOD
Mailing Address - State:MO
Mailing Address - Zip Code:63144-2817
Mailing Address - Country:US
Mailing Address - Phone:314-647-1100
Mailing Address - Fax:314-647-1120
Practice Address - Street 1:8083 MANCHESTER RD
Practice Address - Street 2:
Practice Address - City:BRENTWOOD
Practice Address - State:MO
Practice Address - Zip Code:63144-2817
Practice Address - Country:US
Practice Address - Phone:314-647-1100
Practice Address - Fax:314-647-1120
Is Sole Proprietor?:No
Enumeration Date:2006-12-23
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MO0161291223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice