Provider Demographics
NPI:1669663886
Name:CHAN, QUINN KIN-WUNG (DMD)
Entity Type:Individual
Prefix:DR
First Name:QUINN
Middle Name:KIN-WUNG
Last Name:CHAN
Suffix:
Gender:M
Credentials:DMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:152 LINCOLN RD STE 1
Mailing Address - Street 2:
Mailing Address - City:LINCOLN
Mailing Address - State:MA
Mailing Address - Zip Code:01773-3832
Mailing Address - Country:US
Mailing Address - Phone:781-728-5455
Mailing Address - Fax:
Practice Address - Street 1:152 LINCOLN RD STE 1
Practice Address - Street 2:
Practice Address - City:LINCOLN
Practice Address - State:MA
Practice Address - Zip Code:01773
Practice Address - Country:US
Practice Address - Phone:781-728-5455
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2007-08-05
Last Update Date:2019-05-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI29010205741223P0700X
NH039491223P0700X
MADN18559321223P0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223P0700XDental ProvidersDentistProsthodontics