Provider Demographics
NPI:1598736399
Name:QUINN, MICHAEL HENRY (DMD, MHS)
Entity Type:Individual
Prefix:DR
First Name:MICHAEL
Middle Name:HENRY
Last Name:QUINN
Suffix:
Gender:M
Credentials:DMD, MHS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:6870 FOX CREEK DR
Mailing Address - Street 2:
Mailing Address - City:CUMMING
Mailing Address - State:GA
Mailing Address - Zip Code:30040-6661
Mailing Address - Country:US
Mailing Address - Phone:404-386-0946
Mailing Address - Fax:
Practice Address - Street 1:655 7TH ST
Practice Address - Street 2:78 MDG/SGD
Practice Address - City:ROBINS AFB
Practice Address - State:GA
Practice Address - Zip Code:31098-2227
Practice Address - Country:US
Practice Address - Phone:478-327-8082
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-01-30
Last Update Date:2011-01-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GA115681223P0300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223P0300XDental ProvidersDentistPeriodontics