Provider Demographics
NPI:1477691194
Name:MCQUADE, CHARLES F (DMD)
Entity Type:Individual
Prefix:DR
First Name:CHARLES
Middle Name:F
Last Name:MCQUADE
Suffix:
Gender:M
Credentials:DMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:10 MAIN ST
Mailing Address - Street 2:SUITE L-1
Mailing Address - City:ANDOVER
Mailing Address - State:MA
Mailing Address - Zip Code:01810-3717
Mailing Address - Country:US
Mailing Address - Phone:978-470-8855
Mailing Address - Fax:978-470-8845
Practice Address - Street 1:10 MAIN ST
Practice Address - Street 2:SUITE L-1
Practice Address - City:ANDOVER
Practice Address - State:MA
Practice Address - Zip Code:01810-3717
Practice Address - Country:US
Practice Address - Phone:978-470-8855
Practice Address - Fax:978-470-8845
Is Sole Proprietor?:Yes
Enumeration Date:2007-02-02
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MA166251223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice