Provider Demographics
NPI:1588013833
Name:QUINN, SAMANATHA I (RDH)
Entity Type:Individual
Prefix:
First Name:SAMANATHA
Middle Name:
Last Name:QUINN
Suffix:I
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 1:15 MEDICAL CENTER LOOP
Mailing Address - Street 2:
Mailing Address - City:VINALHAVEN
Mailing Address - State:ME
Mailing Address - Zip Code:04863-4119
Mailing Address - Country:US
Mailing Address - Phone:207-863-2533
Mailing Address - Fax:207-863-9358
Practice Address - Street 1:15 MEDICAL CENTER LOOP
Practice Address - Street 2:
Practice Address - City:VINALHAVEN
Practice Address - State:ME
Practice Address - Zip Code:04863-4119
Practice Address - Country:US
Practice Address - Phone:207-863-2533
Practice Address - Fax:207-863-9358
Is Sole Proprietor?:No
Enumeration Date:2016-06-08
Last Update Date:2016-06-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MERDH3777124Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes124Q00000XDental ProvidersDental Hygienist