Provider Demographics
NPI:1376006437
Name:QUINN, LAUREN A (RDH)
Entity Type:Individual
Prefix:
First Name:LAUREN
Middle Name:A
Last Name:QUINN
Suffix:
Gender:F
Credentials:RDH
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:31 GREENWOOD ST
Mailing Address - Street 2:
Mailing Address - City:ELIOT
Mailing Address - State:ME
Mailing Address - Zip Code:03903-1802
Mailing Address - Country:US
Mailing Address - Phone:207-475-9164
Mailing Address - Fax:
Practice Address - Street 1:74 STATE RD STE 202
Practice Address - Street 2:
Practice Address - City:KITTERY
Practice Address - State:ME
Practice Address - Zip Code:03904-1562
Practice Address - Country:US
Practice Address - Phone:207-752-2968
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2019-04-07
Last Update Date:2019-04-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MERDH2220124Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes124Q00000XDental ProvidersDental Hygienist