Provider Demographics
NPI:1629108857
Name:QUEST JOHNSON ORTHODONTICS, PC
Entity Type:Organization
Organization Name:QUEST JOHNSON ORTHODONTICS, PC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:WILLIAM
Authorized Official - Middle Name:JOSEPH
Authorized Official - Last Name:QUEST
Authorized Official - Suffix:
Authorized Official - Credentials:DDS, MS
Authorized Official - Phone:317-834-4933
Mailing Address - Street 1:203 N INDIANA ST
Mailing Address - Street 2:
Mailing Address - City:MOORESVILLE
Mailing Address - State:IN
Mailing Address - Zip Code:46158-1508
Mailing Address - Country:US
Mailing Address - Phone:317-834-4933
Mailing Address - Fax:317-834-4935
Practice Address - Street 1:203 N INDIANA ST
Practice Address - Street 2:
Practice Address - City:MOORESVILLE
Practice Address - State:IN
Practice Address - Zip Code:46158-1508
Practice Address - Country:US
Practice Address - Phone:317-834-4933
Practice Address - Fax:317-834-4935
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-03-06
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IN12008607A1223X0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1223X0400XDental ProvidersDentistOrthodontics and Dentofacial OrthopedicsGroup - Single Specialty