Provider Demographics
NPI:1548749336
Name:QUINCY ADAMS DENTAL ASSOC., INC
Entity Type:Organization
Organization Name:QUINCY ADAMS DENTAL ASSOC., INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:JOSEPH
Authorized Official - Middle Name:A
Authorized Official - Last Name:DIMARTINIS
Authorized Official - Suffix:JR
Authorized Official - Credentials:DMD
Authorized Official - Phone:617-773-3530
Mailing Address - Street 1:23 RUSSELL PARK
Mailing Address - Street 2:
Mailing Address - City:QUINCY
Mailing Address - State:MA
Mailing Address - Zip Code:02169-4304
Mailing Address - Country:US
Mailing Address - Phone:617-773-3530
Mailing Address - Fax:617-773-5161
Practice Address - Street 1:23 RUSSELL PARK
Practice Address - Street 2:
Practice Address - City:QUINCY
Practice Address - State:MA
Practice Address - Zip Code:02169-4304
Practice Address - Country:US
Practice Address - Phone:617-773-3530
Practice Address - Fax:617-773-5161
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2018-08-13
Last Update Date:2018-08-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MA9657261QD0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QD0000XAmbulatory Health Care FacilitiesClinic/CenterDental