Provider Demographics
NPI:1497957492
Name:QUINCY ENDODONTICS INC.
Entity Type:Organization
Organization Name:QUINCY ENDODONTICS INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:YEAN
Authorized Official - Middle Name:
Authorized Official - Last Name:WU-YOUNG
Authorized Official - Suffix:
Authorized Official - Credentials:DMD
Authorized Official - Phone:617-657-0800
Mailing Address - Street 1:67 CODDINGTON ST
Mailing Address - Street 2:SUITE 102
Mailing Address - City:QUINCY
Mailing Address - State:MA
Mailing Address - Zip Code:02169-4511
Mailing Address - Country:US
Mailing Address - Phone:617-657-0800
Mailing Address - Fax:617-657-5135
Practice Address - Street 1:67 CODDINGTON ST
Practice Address - Street 2:SUITE 102
Practice Address - City:QUINCY
Practice Address - State:MA
Practice Address - Zip Code:02169-4511
Practice Address - Country:US
Practice Address - Phone:617-657-0800
Practice Address - Fax:617-657-5135
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-06-01
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MA196991223E0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1223E0200XDental ProvidersDentistEndodonticsGroup - Single Specialty